HIV Can Affect Your Brain. Get To Know What Is HIV Dementia

As you know, Human Immunodeficiency Virus (HIV) patients can get Acquired Immunodeficiency Syndrome (AIDS ) if the disease is not detected and treated early. When a person gets AIDS, they may develop various complications including in the nervous system and brain. One of the complications is known as HIV-associated neurocognitive disorder (HAND). If this happens, it causes a deterioration in the mental health and cognitive impairment of the individual.

What Is HIV Dementia?

If you know an individual with HIV, you need to know what HIV dementia is. Dementia is a manifestation of some cognitive symptoms due to injury or disorder to the brain. Usually, dementia occurs in the elderly and the causes of dementia may include injuries to brain tissue due to accidents, blood vessel problems, neurological degeneration diseases, alcohol use and so on. HIV-associated neurocognitive disorder (HAND) also occurs as a result of injury to brain tissues when the infection is not treated and spreads to that part of the brain.

There are three levels of HIV-associated neurocognitive disorder (HAND):

Asymptomatic Neurocognitive Impairment

For this condition, the individual does not show any serious symptoms or only shows mild symptoms and the symptoms do not significantly interfere with the individual's daily activities.

Mild Neurocognitive Disorder

At this stage, individuals will have cognitive impairment and the symptoms marked interference with day-to-day functioning.

HIV-Associated Dementia (HAD)

If a person's cognitive abilities deteriorate to the point of not being able to function like a normal human being and need assistance in daily activities, a diagnosis of dementia will be given to the individual. HAD is also known as AIDS Dementia Complex (ADC).

Symptoms of HIV Dementia

Individuals who experience symptoms of HIV dementia can experience symptoms that are divided into early and more serious stages. 

Early symptoms:

• Loss of memory 

• Difficulty in thinking and processing thoughts

• Behavioural changes

• Deteriorated work performance

• Difficulty concentrating

• Inability to learn new things

• Lack of sexual desire

• Apathy; have no emotions or are difficult to understand

• Depression

• Anhedonia; unable to enjoy favourite things or pleasurable activities such as hobbies or social activities

If the initial symptoms is not detected or treated, the condition can cause more serious symptoms, such as:

• Sleep disorders

• Seizures

• Inability to do daily activities on their own and become dependent on others

• More serious mental disorders such as psychosis and mania

Psychosis is a disorder of the way of thinking caused by several factors such as genetics, head or brain injury, disease, medications or drugs. Psychosis causes a person to experience delusions in which the individual believes in non-existing or false facts. Such individuals may also experience hallucinations that can be felt by certain senses such as hearing or sight. 

Mania, on the other hand, is a condition in which a person has a lot of energy and experiences mood swings. During this time, individuals experiencing episodes of mania will experience feelings of euphoria (too happy) or in simple language, high. Besides, the individual will also experience delusions, hallucinations, is full of energy and tend to do high-risk things recklessly such as having unprotected sex or hurting themselves. 

Diagnosis 

The diagnosis of HAD or ADC needs to meet specific criteria. Typically, if an individual is confirmed HIV positive and shows symptoms of dementia, neurological or psychological symptoms, a diagnosis of HAD will be elicited. This should also be supported by a thorough investigation of the medical history as well as the results of laboratory tests and radiological investigation to rule out other diagnoses that may cause similar symptoms. Among the tests performed are:

• CT or MRI of the brain

• Spinal fluid analysis (lumbar puncture)

• Toxicological tests to trace drugs

• Electroencephalography

• Test for HIV, syphilis, hepatitis B

• Electrolyte levels

• Neuropsychological tests

Neuropsychological tests are important tests to be performed on patients who show psychological and neurological symptoms. The symptoms shown by the patient during the test can be used as a guide in planning the best treatments. This test involves the ability to think, the level of anxiety and whether the patient has delusions or hallucinations. The components of this test are done to examine several cognitive abilities such as time and place, memory, attention, the ability to use language or communicate, and the ability to follow instructions.

Treatment

Treatment for HAD is divided into drug and non-drug therapy. Both of these treatments are important to ensure the condition does not become more serious, maintaining or improving cognitive function. Therefore, monitoring and support need to be done to ensure that patients adhere to prescription medications given to control and treat dementia as well as HIV/AIDS.

Non-Medical Treatment

This treatment is done just like other forms of dementia (alcohol, degenerative and other causes of dementia). The purpose of this treatment is to ensure that the patient is sensitive to the surroundings and can perform daily tasks without much help from others and subsequently be independent. The steps and advice that can be given to patients and family members includes:

• Make sure the patient is always with known individuals such as close family members. If the condition improves, the patient can see other family members and friends. The goal is to keep the patient emotionally stable and having a good mental health.

• Stay active; Exercise and any physical activities can help in maintaining one's physical and mental health

• Doing activities that involve the mind; Frequently doing stimulating activities that involve the mind is good to prevent dementia from getting worse. Helpful activities include playing chess, crossword puzzles and reading.

• Explain the dementia condition to family members. A good explanation can help family members in dealing with and managing patients more effectively. The explanation that needs to be given includes a description of the disease and its relation to the patient's condition at the time, complications and how to deal with the condition or what steps need to be taken if complications occur.

• Give moral support and counselling to patients and family members because a high level of patience is required in managing dementia patients.

Medical Treatment 

Medical treatment is emphasized on HIV/AIDS drugs. For this treatment, patients must adhere to the doctor's instructions and prescriptions to keep their HIV condition under control. Apart from HIV medications, other medications can also be used to relieve and control symptoms such as antipsychotic or antidepressant medications. However, the cause of the patient's behavioural changes must be known before any medication or treatment is given to detect the main cause and treat it with the right treatment.