The HAND Database: Overview


What is HAND?

      Although great strides have been made toward extending and improving the lives of those with human immunodeficiency virus (HIV), our ability to control direct viral damage to the HIV-1 individual’s brain remains highly limited [1]. The majority of anti-retroviral therapies exhibit a relatively poor ability to cross the blood brain barrier and enter the brain, and even low levels of viral protein products have been shown to directly damage both neurons and the synapses between them where communication occurs [2, 3]. As a result, of the over 35 million individuals infected with HIV-1 worldwide, over half of this population suffers from HIV-1-neurocognitive disorder (HAND) [4]. Those affected not only have difficulty performing day-to-day activities, but are at a three fold increased risk of death, making this a crucial area of research [5, 6, 7].

What is the HAND Database?

      The HAND Database is a comprehensive and carefully curated compilation of viral sequence data and associated clinical information from HIV-1 individuals assessed for HAND. This database includes data from individuals that have tested positive for HAND, and data from individuals that have tested negative for HAND, providing a large control group for HAND-related analyses. Patient clinical information and sequence data were collected and are periodically updated from the literature, the National Institutes of Health genetic sequence database (GenBank), the Los Alamos HIV sequence database, and through communication with publication authors.

      It's important to note that HAND diagnosis methodologies vary widely [8], with both HAND assessment and documentation continuously evolving along with our understanding of the condition. Post-mortem methodologies include evaluation of patient clinical history and neuropathological examination of brain tissue at autopsy. Pre-mortem assessments include use of the American Academy of Neurology Task Force dementia rating scale, the Memorial Sloan-Kettering scale, and derivation of a mean deficit score from specialized HIV-related neuropsychological deficit tests. Inclusion of PubMed identifiers alongside each sequence in the HAND Database offers access to HAND diagnosis details.

      To the best of our knowledge, this is the largest HAND-dedicated database publically available. Sequences included derive from twenty different tissue types, five geographical regions, and cover the five HIV-1 genes, gag, pol, env, tat, and nef. Information on additional data included in the HAND Database can be found on our help page.


Manuscript under revision: Tess Griffin, Ming Zhang. The HAND Database: A Centralized Gateway to HIV-1-Associated Neurocognitive Disorder Research. 2015.

  1. Cardenas VA, Meyerhoff DJ, Studholme C, Kornak J, Rothlind J, Lampiris H, et al. Evidence for ongoing brain injury in human immunodeficiency virus-positive patients treated with antiretroviral therapy. J Neurovirol 2009,15:324-333.
  2. Kaul M, Garden GA, Lipton SA. Pathways to neuronal injury and apoptosis in HIV-associated dementia. Nature 2001,410:988-994.
  3. Zheng J, Zhuang W, Yan N, Kou G, Peng H, McNally C, et al. Classification of HIV-I-Mediated neuronal dendritic and synaptic damage using multiple criteria linear programming. Neuroinformatics 2004,2:303-326.
  4. Heaton R, Clifford D, Franklin D, Woods S, Ake C, Vaida F, et al. HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy CHARTER Study. Neurology 2010,75:2087-2096.
  5. McArthur J. Update on the Neurological Manifestations of HIV. In: The PRN Notebook; 2005. pp. 1-6.
  6. Mcarthur JC, Steiner J, Sacktor N, Nath A. HIV-associated neurocognitive disorders: ‘Mind the gap’. In: Ann Neurol 2010;67(6):699-714.
  7. Ellis RJ, Deutsch R, Heaton RK, Marcotte TD, McCutchan JA, Nelson JA, Abramson I, Thal LJ, Atkinson JH, Wallace MR, Grant I. Neurocognitive impairment is an independent risk factor for death in HIV infection. JAMA Neurology 1997,54:416-424.
  8. Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, Clifford DB, Cinque P, Epstein LG, Goodkin K, Gisslen M, Grant I, Heaton RK, Joseph J, Marder K, Marra CM, McArthur JC, Nunn M, Price RW, Pulliam L, Robertson KR, Sacktor N, Valcour V, Wojna VE. Updated research nosology for HIV-associated neurocognitive disorders. Neurology 2007,69(18):1789-1799.


Ming Zhang Group, University of Georgia