AIDS dementia complex (patient information)

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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.

Overview
AIDS (acquired immune deficiency syndrome) is a condition that occurs in the most advanced stages of human immunodeficiency virus (HIV) infection. It may take many years for AIDS to develop following the initial HIV infection.

Although AIDS is primarily an immune system disorder, it also affects the nervous system and can lead to a wide range of severe neurological disorders.

What are the symptoms of AIDS dementia complex?

 * Confusion
 * Forgetfulness
 * Behavioral changes
 * Headaches
 * Progressive weakness
 * Loss of sensation in the arms and legs
 * Cognitive motor impairment or damage to the peripheral nerves is also common

What causes AIDS dementia complex?

 * In the United States, neurological complications are seen in more than 50 percent of adults with AIDS.


 * The virus does not appear to directly invade nerve cells but it jeopardizes their health and function. The resulting inflammation may damage the brain and spinal cord and cause symptoms.


 * Research has shown that the HIV infection can significantly alter the size of certain brain structures involved in learning and information processing.


 * Milder cognitive complaints are common and are termed HIV-associated neurocognitive disorder (HAND).

Diagnosis
Neuropsychologic testing can reveal subtle deficits even in the absence of symptoms

Treatment options

 * No single treatment can cure the neurological complications of AIDS. Some disorders require aggressive therapy while others are treated symptomatically.


 * Neuropathic pain is often difficult to control.
 * Medicines range from analgesics sold over the counter to antiepileptics, opiates, and some classes of antidepressants.
 * Inflamed tissue can press on nerves, causing pain. Inflammatory and autoimmune conditions leading to neuropathy may be treated with corticosteroids, and procedures such as plasmapheresis (or plasma exchange) can clear the blood of harmful substances that cause inflammation.


 * Treatment options for AIDS- and HIV-related neuropsychiatric or psychotic disorders include antidepressants and anticonvulsants.
 * Psychostimulants may also improve depressive symptoms and combat lethargy.
 * Antidementia drugs may relieve confusion and slow mental decline.
 * Benzodiazepines may be prescribed to treat anxiety.
 * Psychotherapy may also help some individuals.


 * Aggressive antiretroviral therapy is used to treat AIDS dementia complex. HAART, or highly active antiretroviral therapy, combines at least three drugs to reduce the amount of virus circulating in the blood and may also delay the start of some infections.

Where to find medical care for AIDS dementia complex?
Directions to Hospitals Treating AIDS dementia complex

What to expect (Outlook/Prognosis)?
When left untreated, AIDS dementia complex can be fatal.

Possible complications

 * Other nervous system complications that occur as a result of the disease or the drugs used to treat it include:
 * Pain,
 * Seizures,
 * Shingles,
 * Spinal cord problems,
 * Lack of coordination,
 * Difficult or painful swallowing,
 * Anxiety disorder,
 * Depression,
 * Fever,
 * Vision loss,
 * Gait disorders,
 * Destruction of brain tissue, and coma.


 * These symptoms may be mild in the early stages of AIDS but can become progressively severe.


 * Nervous system complications in children may include:
 * Developmental delays,
 * Loss of previously achieved milestones,
 * Brain lesions,
 * Nerve pain,
 * Smaller than normal skull size,
 * Slow growth,
 * Eye problems,
 * Recurring bacterial infections.

Source
http://www.ninds.nih.gov/disorders/aids/detail_aids.htm