The Centers for Disease Control and Prevention has estimated that at the end of 2006, more than 1.1 million people in the United States had HIV. As HIV progresses into AIDS, patients can develop neuropsychological conditions, such as delirium; however, delirium symptoms may also begin when the patient initially becomes infected with the virus. The American Psychiatric Association says delirium affects 43 percent of HIV patients and 65 percent of AIDS patients.
Risk Factors
Certain HIV and AIDS patients have a higher risk of developing delirium. For example, the HIV Clinical Resource of the New York State Department of Health notes that patients who have had infections that affected the central nervous system, which includes the brain and spinal cord, have a higher risk of developing delirium. HIV- and AIDS-related delirium may also occur in patients who have AIDS dementia complex. The risk of delirium is also higher in HIV and AIDS patients who have had head and brain injuries or opportunistic infections, which develop in patients who have severely compromised immune systems.
Symptoms
HIV- and AIDS-related delirium affects behavior and cognitive functions. For example, delirium can cause paranoid delusions, visual hallucinations and illusions. The Department of Health & Human Services' National Guideline Clearinghouse points out that patients can have problems with judgment, memory, and thinking abstractly and sequentially. Patients may feel tired during the day and have problems sleeping at night. Delirium can also affect verbal ability. Other possible symptoms of HIV- and AIDS-related delirium include involuntary eye movements, lack of muscle coordination and jerking movements.
Diagnosis
The American Psychiatric Association explains that the biggest difficulty in diagnosing delirium in HIV and AIDS patients is distinguishing delirium from dementia. The doctor will note the onset of the symptoms: If they occurred suddenly, the patient has delirium; if they occurred over time, the patient has dementia. The doctor will also interview the patient and family members to gather information on the patient's condition.
Treatment
The National Guideline Clearinghouse gives a three-point treatment plan for HIV- and AIDS-related delirium. The first step is getting the patient to a hospital. If another condition contributed to the onset of the delirium, the doctor will treat that condition. For example, if the patient's antiretroviral drugs for HIV or AIDS caused the delirium, the doctor may change the dosage or drug used. Patients may take a low dose of an antipsychotic to treat the symptoms of the delirium. The doctor may or may not combine the antipsychotic with lorazepam, a type of benzodiazepine. The third step involves consulting a psychiatrist, who can provide counseling.
Prognosis
Delirium in HIV and AIDS patients develops quickly and may lead to stupor or a coma if not properly treated. The American Psychiatric Association points out that 20 percent of HIV and AIDS patients with delirium die. Recovery is possible with treatment, though the American Psychiatric Association recommends that patients should receive education on risk factors for delirium in an effort to prevent it from occurring again.
