Do you know someone who has HIV? Having Human immunodeficiency virus or HIV is starting to become an open concept or topic in this day and age. There are now more people opening up about the disease, and many are listening to what they have to say. For people who live with HIV and the effects it has on their bodies, the prejudice is useless if not damaging because not only is it discriminatory, but it also makes them feel outcasts and socially unacceptable. We judge them without even considering the effects of the disease on their bodies, how the virus lowers their bodies’ immune system to fight off infections and diseases. One of the body parts that are easily attacked by these harmful microbes is the brain, causing different cerebral diseases like HIV associated dementia. Let us discover what HIV associated dementia is, how is it different from cognitive dementia, its symptoms, diagnosis, and treatment.
HIV associated dementia: The relationship
There are so many topics that need to be discussed about HIV, but let us turn our attention to a cognitive condition that is linked with this virus. We all know that when HIV attacks any part of the body, its function and processes may be compromised and may even develop new medical conditions. One of which is HIV associated dementia, also called the AIDS dementia complex, a neurocognitive condition that develops when the virus reaches the nervous system, particularly the brain.
Causes of HIV associated dementia
HIV encephalopathy. As HIV attacks the brain, its functions become affected and may cause dementing symptoms.
Different brain infections. Because the virus weakens the body’s immune system, the brain and the nervous system become susceptible to different infections like meningitis, toxoplasmosis, fungal or bacterial invasions, and even cancer. These brain diseases can also cause dementia that is associated with HIV.
Signs and symptoms of HIV-associated dementia
The clinical manifestations of dementia on HIV patients are highly similar to those shown by non-HIV patients. Objectively, the patient’s brain is viewed through images to be swollen (encephalitis), and changes in cognitive functions affecting a patient’s memory, decision-making skills, judgment, reasoning, focus, and concentrating ability may be noticeable as the disorder develops.
Verbal communication may also be impaired as the patient’s thought process and vocabulary become disrupted. Emotional health also suffers as part of the brain that controls a person’s feelings of excitement and joy becomes damaged. The gradual loss of motor function or involuntary movements will then be manifested as the disease progresses.
How is HIV encephalopathy or dementia diagnosed?
Many diseases can be associated with HIV since it makes the whole body vulnerable to harmful microbes and disease-causing germs. But to put the focus on what HIV can do to a patient’s cognitive capabilities, let us tackle how doctors get to diagnose a patient’s dementing problem and associate it with HIV.
For patients not identified with HIV, diagnosis of dementia can be made through the following tests:
- Clinical evaluation and comprehensive consultation
- Mental health status exam
- Neuropsychological tests
- Complete physical examination
- Electroencephalography (EEG)
- MRI or CT scan imaging to visualize the brain
- Blood and spinal fluid tests
In addition to these exams, if the patient declares that he has HIV or he also shows signs of having HIV, the doctor may request tests to confirm the immune disease.
- Antibody/antigen tests
- Separate antibody test
- Nucleic acid test
- CD4 Lymphocyte test
- HIV viral load test
Treatment for HIV associated dementia
For doctors who are treating HIV patients suffering from dementia, their first priority is always to control the virus. Since HIV is the main reason why dementia developed, doctors prescribe retroviral medications, particularly highly active antiretroviral therapy (HAART), to target the virus itself so that symptoms and other complications associated with the virus gets reduced and managed. The extent of giving medications to a patient with HIV-associated dementia is determined by the patient’s age, general health, medical history, medication tolerance, and your doctor’s expertise.
Other treatments that can help manage HIV-associated dementia include:
- Counseling in regard to alcoholism or drug addiction
- Prescription of antidepressants, anti-anxiety drugs, and brain stimulants
- Lifestyle modification (Exercise, strict routines, environment changes)
- Supportive measures like safety precautions and activity restrictions and limitations
- Encouraging mental exercises like crossword puzzles, scrabble, mind games, and reading
- Socialization, especially to the patient’s closest social circle
Can HIV associated dementia be prevented?
Because HIV can target any part of the body, there is no way to know which part will be affected and when. What doctors do is to manage the HIV itself so that if it already affects one part of the body, it can be contained to that part alone and spread is prevented. So, just to answer the question, if the brain is not yet affected by HIV, aggressive HIV treatments like highly active antiretroviral therapy (HAART) can prevent dementia from developing. But if the brain is already affected, doctors can only manage the severity and spread of HIV.
Prognosis of dementia in HIV patients
This can have two possible outlooks. For patients who were diagnosed early with HIV, chances of developing severe dementia are slim if aggressive and continuous treatments are enforced. However, if the virus gets detected late in its development and the patient no longer responds to antiretroviral medications, the prognosis is poor for both HIV infection and its associated dementia. It can even progress to the point where the patient is no longer capable of caring for himself.