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There is a concern among older adults with HIV about cognitive impairment and related changes in the brain. A longitudinal study of 123 virologically-suppressed HIV patients (median age 56 years) and 78 similar HIV-negative individuals (median age 57 years) used neuropsychological assessment and brain imaging at baseline and 2 years later to address this question. At baseline the people with HIV had poorer cognitive performance, lower gray matter volume with higher white matter intensity and abnormal striation than the comparison group. Importantly, longitudinally, there were no significant changes in any neuroimaging measures or other differences between the two groups. Also cognition was similar in the two groups over time. The conclusion reached by the authors is that with adequate treatment there is no evidence of deterioration of cognitive function or brain morphology over 2 years with adequate treatment. However, it is possible that a longer follow-up period might result in future changes.