HIV: Current Research
Open Access

HIV-Associated Dementia: A Neurocognitive Disorder

Obeagu Emmanuel Ifeanyi^{* *}Correspondence: Obeagu Emmanuel Ifeanyi, Department of University Health Services, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria, Email:

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AIDS dementia is also called HIV-associated dementia. It is a serious consequence of HIV infection and is seen in advanced stages of the disease. Purely HIV-associated dementia is caused by neuronal damage by the HIV virus. In patients with HIV infection, dementia may result from other disorders, some of which may be treatable. These disorders include other infections, such as secondary infection with JC virus causing progressive multifocal leukoencephalopathy, and Central Nervous System (CNS) lymphoma.

IDS dementia complex is caused by the HIV virus itself, not by the opportunistic infections that occur commonly in advanced HIV. We do not know exactly how the virus damages brain cells. HIV may affect the brain through several mechanisms. Viral proteins may damage nerve cells directly or by infecting inflammatory cells in the brain and spinal cord. HIV may then induce these cells to damage and disable nerve cells. HIV causes inflammation, which can cause memory issues, aging processes, including heart disease.

Although the specific symptoms vary from person to person, they may be part of a single disorder known as AIDS dementia complex, or ADC. Common symptoms include decline in thinking, or cognitive functions such as memory, concentration, reasoning, judgment and problem solving. Other common symptoms are changes in speech problems, personality and behavior, and motor problems such as clumsiness and poor balance. Other symptoms of early dementia include reduced productivity at work, difficulty learning new things, changes in behaviour, poor concentration, mental slowness, forgetfulness, and confusion, withdrawal from hobbies or social activities and depression.

Examination and evaluation are essential in determining the presence and extent of the dementia. In addition to a complete medical history and extensive neurological motor and sensory exam, diagnostic procedures for dementia may include mental status test, magnetic resonance imaging, computed tomography scan, neuropsychological testing, basic tests of physical abilities or movement, spinal fluid test.

Specific treatment for HIV-associated dementia will be determined by your health care provider based on the extent of the problem, age, overall health, and medical history, tolerance for specific medications, procedures, or therapies, expectations for the course of the disorder.

People who are using highly active antiretroviral therapy, known as HAART, are less likely to develop HIV-associated dementia. Experts think this may be because these drugs help to maintain the overall immune system. A milder form of cognitive impairment called HIV-associated neurocognitive disorder.

Depending on your level of dementia, various therapies may be required. HIV-associated dementia is a progressive condition, meaning that it will continue to get worse, and the amount of care needed to manage the disease will increase over time.

Congenital Human Immunodeficiency Virus Risk during Pregnancy

Human Immunodeficiency Virus (HIV) is the virus which is responsible for causing Acquired Immune Deficiency Syndrome (AIDS). The virus destroys or impairs cells of the immune system and destroys the body's ability to fight infections and certain cancers. In adults and adolescents, HIV is most commonly spread by sexual contact with an infected partner.

HIV can pass from mother to baby during pregnancy or birth or via breastmilk. Mothers infected with HIV usually do not have any symptoms unless she has very recently been infected, or has had the infection for a long time and has progressed to AIDS. If she was recently infected, she may have cold or flu-like symptoms.

HIV can be transmitted to the fetus or the newborn during pregnancy, during labor or delivery, or by breastfeeding. Only blood, semen, vaginal fluids, and breast milk have been shown to transmit infection to others. The virus is not spread to infants by casual contact, such as hugging or touching, touching items that were touched by a person infected with the virus, such as towels, saliva, sweat, or tears that is not mixed with the blood of an infected person.

HIV-positive women who are on treatment and have stable undetectable viral load, have a 1-2% chance of transmitting HIV to their baby if they breastfeed for 12 months. So, although it is unlikely that a woman will transmit HIV to her baby when breastfeeding it is currently advised not to breastfeed.

It is important to know that not all antiretroviral medications are safe during pregnancy, and some small treatment changes may be required. Pregnancy can be relatively safe for an HIV-positive mother and her baby – if HIV transmission reduction strategies are followed. For HIV-positive women, ways to reduce the risk of transmission include taking antiretroviral medications before conception to reduce your viral load. The lower the viral load, the lower the risk of transmission to your unborn baby.

The care of HIV-infected pregnant women is complex, and multiple issues must be addressed, including the current and future health of the woman, minimization of the risk of maternal-infant HIV transmission, and maintenance of the well-being of the fetus and neonate. Several maternal and obstetrical factors influence transmission rates which can be reduced by optimal medical and obstetrical care.

It is essential that health care workers providing care to these women fully understand the natural history of HIV disease in pregnancy, the factors that affect vertical transmission and the management issues during pregnancy. Close collaboration among a multidisciplinary team of knowledgeable health professionals and, most importantly, the woman herself can improve both maternal and infant outcomes. Careful systematic research is needed for many aspects of HIV in pregnancy.