Cytomegalovirus (CMV) is a herpes virus. It is very common, infecting up to 80% of people in the U.S. by age 40. Normally, it hides out in the body. This is not a problem for most people because a healthy immune system can easily control it. However, it can cause severe disease in people with HIV (human immunodeficiency virus). It's able to take advantage of a weakened immune system, which is why it's called an opportunistic infection. The most common illness CMV causes is retinitis, an eye infection...
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.
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).
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.