Introduction:
Acquired immunodeficiency syndrome (AIDS) is a severe health condition caused by the human immunodeficiency virus (HIV). AIDS is a life-threatening disorder wherein the immune system becomes damaged, which affects the body's ability to fight against other infections and diseases. Though HIV is transmitted dominantly through sexual contact, it can also spread through blood contact from one infected person to another. AIDS has a lot of complications like weight loss, liver and kidney diseases, certain types of cancers, and a decline in the mental process known as dementia.
What Is AIDS Dementia?
AIDS dementia is a condition where the HIV-infected person loses his mental processing capabilities. This is one of the common complications in advanced cases of HIV infection. The condition is also known as HIV-associated dementia, HIV or AIDS encephalopathy, and AIDS dementia complex (ADC).
The affected person will begin to experience worsening of their cognitive and problem-solving capabilities. They will start to lose their:
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Concentration.
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Memory.
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Change in their personality and behavior.
As a result, they will become clumsy and have troubled motor movement or poor balance.
Dementia in AIDS-affected people is marked when the CD4+ count falls less than 200 cells/microliter. Advancement in medicine and technology has effectively prevented dementia in HIV-infected persons through antiretroviral therapy (ART).
What Are the Causes of AIDS Dementia?
AIDS dementia is caused by the human immunodeficiency virus when the person's immune system becomes down and not by any other infections. The doctors are not entirely sure how HIV affects the brain cells but are confident that there is no other viral or bacterial involvement. Some of the theories on how HIV affects the brain cells include:
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The viral protein damages the nerve cells directly.
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Viral protein indirectly affects the inflammatory cells in the brain and spinal cord.
The human immunodeficiency virus is capable of causing generalized inflammation and can cause memory, aging, and heart-related conditions.
What Are the Symptoms of the AIDS Dementia Complex?
Dementia in AIDS patients will occur only at more advanced stages. Symptoms might differ from one person to another, but they begin very subtle in most people and then gradually become troublesome. Dementia will affect people's thinking, memory, behavior, and movement. Other than this, the person will experience symptoms associated with early dementia, and they are:
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Mental slowness.
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Reduced productivity.
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Behavioral changes.
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Lack of concentration.
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Confusion.
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Apathy.
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Depression.
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Decreased libido.
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Forgetfulness or troubled memory.
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Word finding difficulty.
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Drifting away from social events and other hobbies.
Some of the symptoms that are associated with severe dementia include:
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Psychosis.
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Hallucinations.
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Sleep disturbances.
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Seizures.
It is essential to slow down these symptoms and prevent them with the help of proper medical intervention. If not, the person might progress into a vegetative state with no awareness of their surroundings and lose their ability to interact with others.
How Is AIDS Dementia Complex Diagnosed?
When a person is HIV infected and starts to experience cognitive decline, restricted motor movement, and change of behavior, then the patient might be suffering from AIDS dementia complex. However, it is vital to consider the fact that there are also other possible reasons behind the occurrence of these symptoms that are not associated with HIV. They are:
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Metabolic disorders.
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Tumor.
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Degenerative brain disease.
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Other infections.
Hence the doctor or the health care professional will conduct a few tests to arrive at a more concrete diagnosis. The diagnosis tests include,
Imaging Tests:
The doctors will ask for a CT (computed tomography) scan or an MRI (magnetic resonance imaging) to visualize any changes in the brain that helps in the diagnosis of the AIDS dementia complex. These imaging tests will help the doctors identify other reasons explaining what the patient is experiencing. Hence they can help rule out other conditions such as stroke, tumor, etc. Also, in ADC, the brain changes become worse over time; therefore, the doctor can assess the progression of the condition with the help of repeated imaging tests.
Laboratory Tests:
No lab test helps us in diagnosing ADC. However, if the doctor asks to perform any tests, their motive will be to rule out other possible reasons that can have similar symptoms, such as infections, etc. The blood sample will be mainly used for these tests, but one other fluid that the doctor might require is called cerebrospinal fluid (CSF). The CSF surrounds the brain and spinal cord and acts as a cushion in case of an accident. By the procedure called a lumbar puncture or a spinal tap, the doctors will take a sample of CSF to check for any abnormalities that can explain these symptoms.
Neuropsychological Tests:
Neuropsychological tests are the most accurate testing method that pinpoints the level of cognitive abilities and brain functions. It involves answering questions and performing specific tasks to assess mental stability and helps narrow down the problem based on the symptoms. Hence it makes the diagnosis easier by ruling out other reasons that are not related. This test is performed by a neurologist, psychologist, or other trained professional. The test will assess the following:
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Concentration span.
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Memory.
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Orientation of time.
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Ability to use words or language.
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Capability to perform tasks.
Electroencephalography:
In this particular test, the brain's electrical activity will be monitored by the doctor with the help of a series of electrodes that gets attached to the head. They also help identify if the person is suffering from seizures and their associated symptoms.
How Is AIDS Dementia Complex Treated?
We all know there is still no cure for AIDS. However, due to the constant research by healthcare professionals, a control method has been identified, whose efficacy differs from one person to another. This particular method is called antiretroviral therapy (ART) and has been proven to reduce or delay the onset of dementia in advanced cases of AIDS.
By performing ART, it is also possible to reverse the cognitive and mental capabilities of a person who is already suffering from ADC. The efficiency and efficacy of the treatment are purely based on the severity and the stage of the condition.
Apart from these specific symptoms, depression and behavioral changes can be managed by antidepressants and antipsychotic drugs. However, they are considered an intermittent solution and are not considered a treatment for ADC.
Conclusion:
For people suffering from AIDS, dementia is one of the common complications during their advanced stages. ART is the only effective treatment option that helps improve the symptoms and delay the onset of dementia. In addition, try to involve the infected person in physical activities and improve their mental health by engaging in activities such as puzzles, etc. Having a healthy social life will reduce the disease progression and help them keep their mind active and balanced.
