HIV and the brain
A lot of people associate HIV as a disease that attacks the immune system enabling opportunistic diseases to manifest, viral loads increase and eventually Aids. But HIV also affects the brain. During the early stages of HIV infection, the virus enters the brain.
This infection can eventually lead to serious conditions like cognitive problems or milder conditions like problems focussing and remembering things. Since the introduction of ARVs, the prevalence of HIV related dementia has decreased but with people living longer with HIV, the milder cognitive conditions are more prevalent.
Neurocognitive impairment refers to reduction in functions in the brain such as speaking, seeing, calculating, processing information, remembering and problem solving. Symptoms include confusion, difficulty finding words, difficulty with coordination and concentration, loss of short term and long term memory, and mood swings.
There a range of disorders that affect the brain from impairment that is asymptomatic (doesn’t really show) to mild neurocognitive impairment to HIV associated dementia which is severe.
How HIV affects the brain and progresses is not well known. What is understood so far is HIV enters the brain during the early stages of infection. HIV causes inflation and the release of toxins from infected cells which causes further damage. Controlling viral replication can decrease brain inflammation and associated dementia, hence ARVs are important in managing neurocognitive impairment. Other factors that contribute to decreased brain function include ageing, depression, drugs, alcohol, vitamin deficiencies, diabetes and high blood pressure. A healthy diet and exercise is important in mitigating impairment.
There are a number of ways to diagnose neurocognitive impairment. The early stages of HIV-associated dementia can be diagnosed using the International HIV Dementia Scale, a simple scoring system that tests recall, skills, speed and memory. A score below 10 is an indication of a need for further investigation. Medical tests that check abnormalities in cerebrospinal fluid, brain scans using CT scans or MRI can reveal signs of abnormalities in the brain.
HIV manifests in various ways not just suppressing the immune system. It also affects the brain. However ARVs, a healthy lifestyle, good food and exercise go a long way in preventing and reversing brain impairment.n
