People with HIV At Risk for AIDS Dementia Complex
There are many types of dementia – Alzheimer’s, Lewy Body dementia, and frontotemporal dementia (Pick’s disease), to mention a few. However, I wasn’t aware of one type of dementia – dementia caused by human immunodeficiency virus (HIV). This type of dementia is known as AIDS dementia complex (ADC), HIV-associated dementia or HIV/AIDS encephalopathy.
Before we go into dementia, let’s have a refresher course on HIV. According to The Body, The Complete HIV/AIDS Resource website, anyone can get HIV. “HIV is a virus; once it gets into your body, it can make you sick. It does so if you are rich or poor; 14 years old or 70; black or white; gay or straight; married or single,” Bonnie Goldman wrote on this site. I also recently posted a column about HIV for HealthCentral’s menopause site. In it, I reported that Womenshealth.gov (which is project of the U.S. Department of Health and Human Services Office on Women’s Health) has stated that almost a quarter of the U.S. population who have HIV are 50 years of age and older. Furthermore, women who are going through perimenopause or menopause have a greater risk of contracting HIV through sexual contact.
So now let’s delve into ADC. According to emedicinehealth.com, ADC occurs as the CD4+ count falls to fewer than 200 cells/microliter. The Body reports that CD4 cells are a type of white blood cell that is an important part of the immune system. These cells are often known as T-cells, of which there are two types. The T-4 cells (also called CD4+) are helper cells that lead the attack against infections. T-8 cells (CD8) are suppressor cells that end the immune response and killer cells that kill cancer cells and cells infected with a virus. A Danish study found that people age 50 or older with HIV had a significantly higher risk of contracting AIDS dementia complex after the initial AIDS diagnosis when compared with people age 30-39 years of age.
The Body website states, “ADC is characterized by severe changes in four areas: a person’s ability to understand, process and remember information (cognition); behavior; ability to coordinate muscles and movement (motor coordination; or emotions (mood). These changes are called ADC when they’re believed to be related to HIV itself rather than other factors that might cause them, like other brain infections, drug side effects, etc.”
Dementia due to HIV infection starts with subtle symptoms that then progress to become troublesome. According to emedicinehealth.com, these symptoms, which can vary from person to person, can include reduced productivity at work, poor concentration, difficulty learning new things, changes in behavior, confusion, apathy, depression, and withdrawal from hobbies and social activities. The signs of worsening dementia related to HIV are problems with speech and balance, clumsiness, muscle weakness, vision problems, and loss of bladder and bowel control. Other symptoms that are rarer include sleep disturbances, psychosis (extreme agitation, loss of contact with reality, inability to respond appropriately to the environment, delusions and hallucinations), mania (hyperactivity, poor judgment, extreme restlessness), and seizures.
Interestingly, ADC may be the first sign that a person has AIDS. However, emedicinehealth.com reports that antiretroviral therapy (HAART) has caused the frequency of ADC to decline form 30-60% of people who are infected with HIV to less than 20%. HAART has been found to improve mental function in people who already have ADC.
Scientists are making some progress in understanding HIV-related dementia. USA Today recently reported that researchers have found two genetically distinct types of HIV in the cerebrospinal fluid of people who have HIV-associated dementia. Researchers believe that these two HIV types, which grow in the central nervous system, may explain why the chances of neurological difficulties increase as AIDS patients live longer.
The good news with this type of dementia is that you actually can prevent it by making the necessary choices to avoid being infected by HIV. Make sure that you never have unprotected sex and you don’t share needles or other equipment that is used to inject drugs with other people.