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AIDS Dementia Complex

Dementia is a condition that leads to the loss of intellectual abilities such as memory, judgment, and abstract thinking. It can also cause changes in personality. AIDS Dementia Complex (or ADC) is a type of dementia that occurs in advanced stages of AIDS (acquired immunodeficiency syndrome). AIDS is a later stage of HIV (human immunodeficiency virus) infection.

ADC leads to a diverse group of symptoms that affect your ability to function in work and life. It can be fatal. Before HIV medications called HAART were available, ADC occurred more frequently. Today, only about 10% to 15% of people with AIDS develop AIDS dementia.

What is AIDS Dementia Complex?

Unlike many other HIV-related problems, ADC is not caused by an opportunistic infection, which takes advantage of a weakened immune system. HIV experts believe that ADC results directly from the HIV infection itself. Although HIV does not infect brain nerve cells, the virus may indirectly kill them. This is more likely to occur as CD4 cell counts decrease to less than 200. CD4 cells are a type of immune system cell. They are also known as T-helper cells.

ADC varies greatly from person to person. Symptoms may progress quickly or slowly. It generally affects four different areas of your brain function:

Thinking abilities
Behavior
Coordination and movement
Mood

Symptoms of AIDS Dementia Complex

The signs and symptoms of ADC can be similar to other HIV-related problems, such as opportunistic infections or medication side effects. This makes it more difficult to diagnose and understand.

These are some of the first signs and symptoms of ADC:

Short attention span
Trouble remembering
Poor judgment
Slowed thinking and longer time needed to do tasks
Irritability
Unsteady gait, tremor, or trouble staying balanced
Poor hand coordination
Social withdrawal or depression

In later stages, you may have more severe symptoms:

Extreme mood swings
Psychosis
Loss of bladder and bowel control

If you think you or someone you love may have ADC, write down the symptoms to share with your doctor. Also, do what you can to put together a support system. Although you can receive treatment for ADC, it may take some time for you to get better.

Diagnosing AIDS Dementia Complex

ADC can be difficult to diagnose. Your doctor will work to rule out other problems, while recognizing that you may have more than one HIV-related problem causing the same symptoms. These are tests your doctor may order if ADC is a possibility:

A mental status exam is the main way to diagnose ADC. It can spot problems such as memory loss, problems with abstract thinking, and mood swings. This exam involves answering questions and performing tasks. The person conducting the test also may assess your speech, appearance, and other aspects of your functioning.
A computed tomography (CT) scan or MRI (magnetic resonance imaging) scan of your brain can help rule out other possible brain disorders. These may include a type of cancer called lymphoma or toxoplasmosis, an infection caused by a parasite. A CT scan uses X-rays to produce detailed images of the inside of your brain. MRI uses magnetism, radio waves, and a computer to produce images of the inside of your brain.
A spinal tap involves examining cerebrospinal fluid from the spinal canal. It can also help rule out other problems.