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AIDS Dementia Complex

(ADC; AIDS Encephalopathy; AIDS-related Dementia; ARD; HIV-associated Dementia Complex; HIV Encephalopathy; HIV Associated Encephalopathy (HAE), HIV associated Cognitive/Motor Complex)

Definition

AIDS dementia complex (ADC) can occur in people with AIDS. ADC results in changes in multiple neurologic areas:
ADC is a common nervous system complication of late-stage HIV infection.
Immune System
Immune system white blood cell
HIV destroys white blood cells vital to the immune system.
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Causes

It is not clearly understood how HIV infection causes ADC.

Risk Factors

Factors that may increase your chance of having ADC include:

Symptoms

Symptoms usually develop slowly and worsen over time. They can be grouped into stages:

Stage 1 (Mild)

  • Difficulty concentrating
  • Difficulty remembering details, such as phone numbers, appointments, or tracking daily activities
  • Slowed thinking
  • Longer time needed to complete complicated tasks
  • Irritability
  • Unsteady walking, tremor, or difficulty keeping balance
  • Poor hand function
  • Change in handwriting
  • Depression

Stage 2 (Moderate)

  • Weakness
  • More focus and attention needed
  • Slow responses
  • Frequently dropping objects
  • Feelings of indifference
  • Slowness or difficulty with normal activities, such as eating or writing
Walking, balance, and coordination require a great deal of effort at this stage.

Stages 3 and 4 (Severe and End Stage)

  • Loss of bladder or bowel control
  • Abnormal gait, making walking more difficult
  • Muteness
  • Withdrawing from life
  • Severe mental disorders, such as psychosis or mania
  • Unable to leave bed

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A mental status/neurological exam may be done.
Your bodily fluids may be tested. This can be done with:
Images may be taken of your bodily structures. This can be done with:
Your brain's electrical activity may be tested. This can be done with an electroencephalogram (EEG).

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Antiretroviral Therapy

Anti-HIV drugs are often used to treat ADC. A medication plan will be created that is right for you. These drugs are often given in combination.

Other Medications

Other medications may be used along with antiretroviral therapy to treat symptoms of ADC. These may include:
  • Antipsychotics
  • Antidepressants
  • Anti-anxiety medications
  • Stimulants
  • Mood stabilizers
  • Medications to prevent seizures

Prevention

ADC occurs in people with HIV. Ways to help reduce your chance of getting HIV include:

RESOURCES

AIDS—U.S. Department of Health and Human Services http://www.aids.gov

The Foundation for AIDS Research http://www.amfar.org

CANADIAN RESOURCES

AIDS Committee of Toronto http://www.actoronto.org

Canadian AIDS Society http://www.cdnaids.ca

References

AIDS dementia complex. University of California at San Francisco website. Available at: http://hivinsite.ucsf.edu/InSite?page=id-01-08. Accessed August 18, 2014.

Luo X, Carlson KA, Wojna V, et al. Macrophage proteomic fingerprinting predicts HIV-1-associated cognitive impairment. Neurology. 2003;60(12):1931-1937.

Meehan RA, Brush JA. An overview of AIDS dementia complex. Am J Alzheimers Dis Other Demen. 2001;16(4):225-229.

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