The HNRC has come to be recognized for its expertise on the neurobehavioral complications of HIV both at the national and international levels. As mentioned above, HNRC investigators contributed fundamentally to the development of the NIMH consensus recommendations for neuropsychological testing in HIV (Butters et al., 1990) and was again involved in a more recent NIH position statement (Bloom & Rausch, 1997). HNRC investigators also contributed to the development of the neuropathological standards for classifying HIV disease (cf, the contributions of Clayton Wiley, while at the HNRC, to the Budka et al., 1991 consensus statement) and most recently, participated in the NIH work group “A Critical Re-Examination of Adequacy and Utility of AAN 1991 Definitional Criteria” (NIMH/NINDS: Frascati, Italy, 6/13/05).
HNRC investigators have also contributed to influential reviews and have participated in many national and international meetings focused on neuroAIDS. For example, Grant and Atkinson co-authored chapters on neurobehavioral complications of HIV for both the 6th and 7th editions of the Comprehensive Textbook of Psychiatry, which is the "Harrison's" of that discipline. HNRC work has also featured prominently in a number of other review articles (Atkinson et al., 1994; Atkinson et al., 1997; Grant, 1990; Grant et al., 1995; Grant et al., 1999; Grant & Martin, 1994; Grant & Heaton, 1990; Heaton et al., 1994; Heaton et al., 1996; Kelly et al., 1996; McArthur and Grant, 1998; Marcotte et al., 1999; Grant et al., 2002; and Marcotte & Scott, 2010).
Nationally, HNRC expertise contributed to the development of common neuropsychological and neuromedical protocols for the National NeuroAIDS Tissue Consortium sponsored by NIH; these protocols have also been implemented in CHARTER, a national, multi-site study of CNS effects of antiretroviral therapy. On the international level, HNRC investigators have NIH-funded collaborations with investigators from China and Brazil, as well as current proposals to study neuroAIDS in India and Romania. As part of the emerging international role of the HNRC, HNRC investigators participated in the “NeuroAIDS in Brazil” review meeting (NIMH/International AIDS Society: Rio de Janeiro, Brazil, 7/29/05). HNRC investigators were also consulted in the development both of the 1988 and 1998 WHO position papers on central nervous system complications of HIV (UNAIDS, 1998). Indeed, the approach taken by the HNRC to clinical ratings of change is fundamental to the WHO approach.