HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome) affect many organs in the human body including the brain which may lead to the development of HIV-associated dementia.
This is also known as AIDS dementia, AIDS dementia complex, or HIV/AIDS encephalopathy.
It is one of the severe consequences of HIV infection.
HIV weakens the immune system of the person it affects which makes it harder for the body to fight diseases and infections.
What is HIV associated dementia?
Dementia caused by HIV can be described as chronic cognitive deterioration that is a result of brain infection by HIV.
It is a complex syndrome that consists of various mental and nervous system symptoms that affect persons with HIV. The HIV infection normally gets to the brain at the later stages of the disease.
While dementia tends to affect elderly persons, AIDS dementia tends to occur in younger persons.
HIV encephalopathy is an infection that spreads through the brain and is one of the primary causes of dementia in persons who have HIV.
Learn about the symptoms and causes of the AIDS dementia complex below.
Causes of HIV-Associated Dementia
When a person has HIV, the virus makes its way to the brain infecting the cells in the organ. This causes encephalopathy a disease that affects the functions of the brain.
The illness then leads to the development of dementia because of the neuronal damage that HIV causes.
The virus also damages the communication between nerve cells which results in impaired cognitive function and impaired communication in the brain.
AIDS dementia is more common in people who are not on anti-HIV drugs.
According to Webmd.com, HIV-associated dementia typically occurs when a person’s CD4+ falls to fewer than 200 cells/microliter. This typically occurs after years of positive HIV diagnosis.
There are several ways HIV can affect the brain.
One of them is through the viral proteins that may directly damage nerve cells or infect the inflammatory cells in the brain as well as the spinal cord.
The virus may then trigger the cells to disable and damage the nerve cells.
HIV usually leads to generalized inflammation which can be the cause of memory problems as well as other aging processes like heart diseases.
While AIDS dementia is not an opportunist infection, since HIV causes neurodegenerative disorder, the exact causes of this disorder can be hard to pinpoint.
This is because several other causes related to HIV can damage the nervous system including:
- Opportunistic infections
- Direct effects of the HIV infection on the brain
- AIDS-related metastasis/lymphoma or other related cancers
- Drug treatments toxic effects
Symptoms of HIV-Associated Dementia
Several symptoms are seen in persons with AIDS dementia. These can show up at different stages of the disease.
At the early stages some of the warning signs that may be prominent include:
- Memory issues affecting both long and short-term memory
- Encephalitis: this is a condition that makes the membranes of the spinal column and those of the brain swell
- Reduced productivity at the workplace
- Problems with spatial skills
- Difficulties staying focused or concentrating
- Inability to learn new skills
- Cognitive impairment where a person experiences reduced ability to think clearly
- Problems with speaking accurately or clearly
- A gradual loss of motor skills
- Lack of enthusiasm in previously enjoyed hobbies and activities
- Taking longer to complete familiar tasks
- Problems taking medicine correctly and following the proper medical advice
- Decreased libido
- Changes in personality and behavior
- Difficulties managing finances
- Trouble keeping balance or an unsteady gait
- Difficulties with decision-making, organizing, and planning
The symptoms are different for people with AIDS dementia complex.
Experts state that mental status tests, as well as other mental capabilities, are usually normal during the onset of the illness.
Because the symptoms tend to develop slowly, some warning signs may come out during the middle stages of HIV-associated dementia like:
- Signs of motor dysfunction like muscle weakness
- Reversing of words or numbers
- Impaired driving
- Frequently dropping objects and slower responses
- Poor performance on daily tasks
- Increased attention and concentration required
- Coordination, balance, and walking requires more effort
- Slowness in activities like writing or speaking
- Feelings of indifference
Worth noting is that dementia symptoms become worse as the infection in the brain becomes more widespread.
Some signs may show up during the later stages of AIDS dementia complex such as:
- Spastic gait which makes walking more challenging
- Loss of bowel or bladder control
- Social withdrawal
- Sleep disturbances
- Confinement to bed
- Loss of initiative
- Mania: extreme hyperactivity, restlessness, poor judgement, and rapid speech
- Psychosis: this is a serious mental disorder where emotions and thoughts are impaired to an extent that a person loses touch with reality. These can also feature extreme agitation, inability to appropriately respond to the environment, delusions, and hallucinations
The above symptoms can make one confused where they are not able to make sense of the world around them.
At times, they can also result in a vegetative state where an individual is incapable of interacting and has minimal awareness of their surroundings.
Symptoms can be similar to other conditions
It is also important to note that some of the HIV-associated dementia symptoms resemble other medical problems and conditions.
These may include depression, other infections, or nutritional deficiencies. For these reasons, it is to best consult a professional health care provider for an accurate diagnosis.
Anyone who has HIV should visit an HIV specialist or GP if they start developing problems with their mood or thinking.
Medical experts acknowledge that people with AIDS dementia complex achieve the best results with early diagnosis and proper treatment.
While some people who have HIV end up developing HIV-associated dementia, some do not.
It is advisable for persons who have been diagnosed with HIV to have their emotional and cognitive wellbeing assessed within three months of the diagnosis.
This should be re-assed after a year so that should any problems arise, they can be addressed as fast as possible.
There is on-going research to determine whether HIV causes dementia to develop faster in an individuals’ brain.
The findings will help determine how a person’s risk of dementia might increase if they have HIV.