Human immunodeficiency virus or HIV affects the whole body by lowering our body’s immune system to fight off infections and diseases. When a person has HIV, his immune system becomes compromised so his body cannot protect and guard itself against harmful bacteria, viruses, and any foreign particles that may cause health problems. One of the parts of the body that can be easily confronted by disease-causing microbes is the nervous system or the brain which may cause HIV associated dementia. Let us discover what HIV associated dementia, how is it different from cognitive dementia, its symptoms, diagnosis, and treatment.

HIV associated dementia: Brief facts about HIV

There are so many misconceptions about HIV, so let us first and foremost help you get to know more facts about this traitorous disease.

All AIDS patients have HIV, but not all HIV patients have AIDS. HIV’s last stage is Acquired Immunodeficiency Syndrome or AIDS. It is the untreated form of HIV. However, there are also other diseases that are associated with HIV, and not all HIV patients get to develop the advanced stage called AIDS.

HIV can be transmitted through blood, semen, vaginal and anal fluids, and breast milk; however, the virus is not present in a patient’s saliva, sweat, or urine.

There is no cure for HIV. Patients inflicted with this virus are given antiretroviral medication which fights off its growth and spread. Early detection of HIV can be beneficial because it was found out that early treatment with antiretroviral medications makes the HIV undetectable in blood tests; thus, the spread or contagion of this virus is lessened as well. This is beneficial especially to mothers who would give birth or breastfeed while being an HIV patient.

Symptoms of HIV

We can determine that HIV can show signs and symptoms of a regular infection, except that upon testing the cause of the infection is different. One can assess the patient as having the following nonspecific symptoms like:

• Headache
• Fever
• Lymphadenitis (swelling of lymph nodes)
• Night sweats
• Fatigue and muscle weakness
• Gastrointestinal problems like nausea, vomiting, diarrhea, etc
• Rashes
• Respiratory problems like cough, colds, pneumonia-like symptoms

HIV associated dementia: The relationship

Now that you know some more information about HIV and its relationship with AIDS, let us turn our attention to a cognitive condition that is related to HIV as well – dementia. Because we all know that HIV can affect any part of the body, its function and processes may be compromised and may even develop new medical conditions that are related to HIV. One of which is HIV associated dementia, also called AIDS dementia complex, a condition that develops when the virus reaches the nervous system, particularly the brain.

Causes of HIV associated dementia

HIV encephalopathy. As the HIV attacks the brain, its functions become affected and may cause dementing symptoms.

Other 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. 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 also gets affected as a patient’s thought process and vocabulary becomes disrupted. Emotional health also suffers as the 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?

There are many diseases that can be associated with HIV since it makes the whole body vulnerable to harmful microbes and disease-causing germs. But to put 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 associate it with HIV.

For patients not diagnosed with HIV, diagnosis of dementia can be done 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 will 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 growth 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. 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.