Dementia, although commonly associated with the elderly, does not always exclusively present in old age. Many forms of degenerative dementia stem from gradual cerebral buildup or some kind of severe damage, but HIV-associated dementia is a variety that stands apart. This kind of dementia only affects those infected with HIV, and can develop at any age.

What Is HIV-Associated Dementia?

As the name suggests, HIV-associated dementia, also known as an AIDS dementia complex, is a neurological condition induced by the pre-existence of an HIV infection or AIDS. It is considered a global brain dysfunction incited by HIV's effects on the immune system—the dysfunction of the body's natural immunities activate macrophages (which engulf and eliminate cellular debris) and microglia (which help maintain homeostasis in the brain). Once these cells become actively infected with the virus, they begin secreting various neurotoxins that negatively influence brain capacity and function. Despite this, levels of the HIV virus present in the brain do not directly correlate with the severity of symptoms, suggesting other mechanisms may be at play.

While some symptoms may begin occurring, the condition can only be formally diagnosed as a form of dementia when it interferes with ordinary function and requires outside assistance. Up to that point, it is considered only a mild neurocognitive disorder.

Risk Factors

The only risk factors for HIV-Associated dementia are a long-standing manifestation of an HIV infection or the presence of AIDS. Symptoms that appear without the previous presence of HIV or AIDS would be diagnosed as a separate form of dementia.

Signs And Symptoms

HIV-associated dementia carries many symptoms similar to other forms of dementia. Symptoms can vary from patient to patient, so diagnosing the disease can be a complicated issue. These include:

  • Problems recalling or creating new memories
  • Frequent distraction
  • Emotional unpredictability, with tendencies toward anger and irritability
  • Physical exhaustion and fatigue
  • Poor physical coordination
  • Depression and social withdrawal
  • Problems comprehending or articulating language
  • Difficulty maintaining attention

Late stages of the condition are characterized by psychotic symptoms, severe loss of vocabulary and verbal memory, physical seizures, and total muteness.

Treatments

Highly active antiretroviral therapy (HAART) is a series of three or four drugs, taken in combination, in order to effectively manage the presence and spread of HIV and AIDS. Keeping the virus at bay has been shown to effectively keep the symptoms of HIV-associated dementia from appearing, or at least keeping the disease from severely progressing. Thus, the onset of HIV-associated dementia can be effectively controlled in most developed nations of the world.

Despite this, HIV-associated dementia is a progressively worsening disease, and can ultimately be fatal if not effectively treated. Through HAART and HIV-specific treatments, the development and progression of the disease can be successfully controlled, but without this treatment, the condition can intensify until the patient's death.

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