HIV associated dementia

Prevalence increased with the use of effective antiretroviral treatment.

Prevalence has increased because patients are living longer.

Incidence has decreased 15-50% since the start of the HAART era.

May be more likely to occur inpatients with higher CD4+ cell counts.

Wide clinical presentation form a minor cognitive motor disorder to severe dementia.

Comorbid factors such as age, drug abuse, coinfections may alter the course of the process and its treatment.

Should be considered in the diagnosis of neurologic manifestations of HIV infection and its treatment.

Associated with impaired cognition, behavioral changes and motor dysfunction.

Associated with the later stages of HIV disease and rare in the asymptomatic phase.

In pre-HAART era minor cognitive-motor disorder developed in 17% of HIV patients and 9% developed dementia with a CD4+ cell count below 200/microL, during a 1 year follow-up (Stern).

In the post-HAART era clinical manifestations are milder, with mixed cognitive phenotypes, higher CD4+ cell counts, and variable progression.

Delirium is often present with cognitive impairment and dementia.

Typically present with subcortical features of apathy, impaired attention, loss of memory, along with psychomotor slowing.

Associated psychosis manifested with agitation, irritability and delusions, and ref2242ed to as AIDS mania.

A diagnosis of exclusion, supported by CSF findings of HIV RNA, and MRI findings.

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