HIV-Related Cognitive Impairment

HIV-associated Dementia (HAD) is a rare condition that causes thinking problems in people who have the human immunodeficiency virus (HIV). HAD is one form of HIV-associated Neurocognitive Disorders (HAND).

People with HAD often have changes in their cognitive skills (thinking and memory) and may have difficulty with movement and behavior. Symptoms of HAD are more likely to develop with a low CD4+ count (less than 200 cells/microliter).

What Causes HIV-Associated Dementia?

HIV-associated dementia can be caused by HIV itself or by a combination of HIV in the blood and external factors. HAD is estimated to occur in less than 5% of HIV-infected individuals who have access to combination antiretroviral therapy (cART).

How is Age Related to HIV-Associated Dementia?

Thinking and behavior changes may get worse for people with HAD as they get older.

What Happens in HIV-Associated Dementia?

People with HAD can have changes in behavior, mood, movement, and/or thinking skills. A person with HAD can have symptoms that vary, and they might be better one day and worse the next. Some people have more trouble with thinking changes such as attention, memory, and concentration. For example, a person with HAD may have trouble following a conversation, remembering phone numbers and appointments, or difficulty understanding questions they are being asked. These problems are often the first to become apparent to the individual and their family members.

In later stages of HIV, movement and behavior symptoms may develop or become worse. People with HAD may begin to have weakness in their legs or difficulty balancing. Mood and behavior problems may also develop later. For example, people with HAD may become depressed, irritable, or uninterested.

A person with HAD can live many years with the disease, although this can vary from person to person. cART may prevent or delay the onset of HAD.

Are There Medicines to Treat HIV-Associated Dementia?

Though there is no cure for HAD yet, there are ways to minimize the risk of developing HAD and to manage the symptoms if present. HAART helps to keep the levels of HIV in the blood very low, and people with HIV who are on HAART have a low likelihood of developing HAD. cART can also help delay cognitive changes associated with HAD.

What Other Things Help?

In addition to medications, there are various ways to help a person with HAD. Research has shown that physical exercise helps to enhance brain health and improves mood and general fitness. A balanced diet, enough sleep, and limited alcohol intake are other important ways to promote good brain health. Other illnesses that affect the brain, such as diabetes, high blood pressure, and high cholesterol, should also be treated if present.