In episode 72 of Going anti-Viral, Dr Alan Winston joins host Dr Michael Saag to discuss a presentation he gave at the 2026 Conference on Retroviruses and Opportunistic Infections (CROI) entitled Neurodegeneration and Dementia Risk in Older Adults With HIV: Biomarkers and Epidemiology. Dr Winston is a Professor of HIV and Genitourinary Medicine at Imperial College London and Consultant Physician at St. Mary’s Hospital, London. His research focuses on noninfectious comorbidities associated with HIV in the modern antiretroviral era, with a strong focus on central nervous system complications. He is the principal clinical investigator on the POPPY study, a cohort study describing the incidence and nature of comorbidities in HIV. Dr Winston and Dr Saag discuss the history and current understanding of neurodegeneration and dementia risk in older adults with HIV and review the impact of antiretroviral therapy and neuroinflammation. They review clinical assessment and screening for dementia and neurodegenerative disease including a detailed discussion of imaging techniques and cerebral spinal fluid (CSF) examination.