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HIV and Dementia

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HIV is often linked with mental decline and worsening motor skills. When the virus attacks someone's nervous system, it can damage their brain and cause HIV-associated neurocognitive disorders (HAND).

Symptoms of HAND include at least two of the following:

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Three Classes of HAND

Asymptomatic neurocognitive impairment. Tests show a decline in mental abilities, but the person's everyday life isn't affected.

Mild neurocognitive disorder. There’s a noticeable change in the person's ability to do everyday tasks.

HIV-associated dementia. This form really limits someone's ability to lead a normal life. People in the later stages can have seizures, psychosis, and loss of bladder or bowel control.

The first two classes have mild to moderate symptoms, and they affect nearly half of people who have HIV. The third, severe form is relatively rare these days. That’s due to the introduction of a drug cocktail called highly active antiretroviral therapy (HAART) in 1996.

Diagnosis

The symptoms of HAND are similar to a number of disorders, so diagnosis can be tricky. Plus, symptoms can vary from one person to the next.

The doctor may do a mental evaluation, brain scan, and spinal tap (a test sample of the fluid surrounding the spinal cord).

Treatment

While there's no cure, the most effective treatment for HIV-associated dementia is HAART, which is known to reduce the amount of HIV in the blood.

Particularly helpful drugs are ones that can cross the blood-brain barrier, like zidovudine (Retrovir). A doctor may also prescribe an antidepressant, an antipsychotic drug, or a psychostimulant (a drug for alertness).

A person with this condition may need help remembering to take their medication.

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on November 18, 2014
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