Acquired immunodeficiency syndrome, or AIDS, can affect patients' brains, causing AIDS dementia complex. Before HIV progresses into AIDS, the condition is called HIV-associated dementia. The virus affects parts of the brain, such as the basal ganglia. As a result, patients have changes in their thinking abilities. AIDS dementia complex patients can also have depression, problems walking and loss of control of their bowels or bladder. Treatment for AIDS dementia complex combines AIDS treatment and supportive measures.
Prevalence
The Merck Manual Professional Edition explains that 7 to 27 percent of patients with late-stage HIV infection develop HIV-associated dementia; however, 30 to 40 percent of patients may have more mild types of this dementia. The prevalence of AIDS dementia complex increases as the CD4 cell count, a type of immune cell monitored in HIV and AIDS patients, goes down. Project Inform adds that the number of AIDS dementia complex cases have decreased since antiretroviral therapy has become a standard part of HIV and AIDS treatment.
Diagnosis
Doctors will perform certain diagnostic scans to determine if a patient has AIDS dementia complex. Part of the diagnostic procedure is to rule out other causes. The Merck Manual Professional Edition points out that MRI scans are better than CT scans in ruling out other problems that can cause dementia, such as progressive multifocal leukoencephalopathy. Doctors may also perform a lumbar puncture, which allows them to test the cerebrospinal fluid, which surrounds the brain and spinal cord. Tests of mental capacities can gauge the severity of the dementia.
Medication
The National Guideline Clearinghouse from the U.S. Department of Health and Human Services points out that antiretroviral and psychotropic drugs can help treat AIDS dementia complex. The antiretroviral drugs work by suppressing the replication of the virus. High doses of certain antiretroviral drugs, such as zidovudine, can cross the blood-brain barrier, which allows it to reach the brain. Other antiretroviral drug options for AIDS dementia complex include amprenavir, stavudine, nevirapine and abacavir sulfate. Doctors use the psychotropic drugs to treat specific symptoms of the dementia. For example, methylphenidate can treat apathy, thorazine can treat agitation and lorazepam can treat anxiety.
Support
The National Guideline Clearinghouse notes that AIDS dementia complex patients can benefit from family support. Patients may also need nursing services at home if they have problems caring for themselves.
Prognosis
If the dementia is not treated, patients have a worse prognosis. The Merck Manual Professional Edition explains that the average life expectancy of an HIV or AIDS patient with dementia is six months.
