Unifying hypothesis for the pathogenesis of HIV-associated dementia complex, vacuolar myelopathy, and sensory neuropathy

Article Abstract:

Neurologic diseases in HIV infected patients may be caused by an increase in macrophages in the nervous system. HIV-associated dementia complex (HADC) occurs in 7% to 14% of AIDS patients and causes impairment of visual, motor, reflexive, and intellectual abilities. Vacuolar myelopathy (VM) occurs in 2% to 55% of HIV patients and causes uncoordinated contraction or partial paralysis of muscles. Sensory neuropathy (SN) occurs in about 30% of HIV patients and causes dysfunction of peripheral nerves. Each of these neurologic diseases occur late in HIV infection. They also involve abnormalities in the sheath that surrounds nerves, leakage of the blood/brain or blood/nerve barrier, and increases in macrophages which produce tumor necrosis factor (TNF)-alpha. TNF-alpha may in turn cause nerve damage. The increased macrophage activity may be caused by a depletion of CD4 T cells which inhibit macrophages.

Complications and side effects, Physiological aspects, Neurologic manifestations of general diseases, Neurologic manifestations

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Low education as a possible risk factor for cognitive abnormalities in HIV-1: findings from the Multicenter AIDS Cohort Study (MACS)

Article Abstract:

HIV-infected individuals who have only 12 years of education or less may have a higher risk of developing intellectual impairment than those with more education. Of 1,773 homosexual and bisexual men who have been followed since 1984, 888 are HIV-positive and 885 are HIV-negative. Overall, 172 (10%) have 12 years of education or less and 1,601 (90%) have more than 12 years of education. None of the HIV-positive men have symptoms of AIDS. All were given several tests to measure attention, verbal fluency, memory and concentration. Overall, 281 men were diagnosed with intellectual impairment. Thirty-eight percent of the HIV-positive men with fewer than 12 years of education had impaired intellectual function, compared to 16% of the HIV-positive men with more than 12 years of education. Men with little education may engage in risky behaviors more frequently.

Health aspects, Education, High school graduates

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HIV dementia scale: a rapid screening test

Article Abstract:

A new assessment tool used to identify HIV dementia may be more effective than other dementia-detecting tests. Researchers developed the HIV Dementia Scale (HDS) using 152 HIV and AIDS patients. The HDS was able to distinguish mild dementia from no dementia in AIDS patients, and could measure severity of dementia. The HDS appears to be more reliable than a standard test used to detect HIV dementia known as the Minimental State Exam (MMSE). The HDS emphasizes tests of motor speed, concentration, and memory, since people with HIV dementia are often deficient in these skills. Identification of HIV dementia in HIV patients and AIDS patients is important because dementia indicates a worse outlook for survival. The HDS is fairly simple to administer.

Testing, Dementia

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