Etiology of HIV-Associated Dementia :: Biology Essays Research Papers

Etiology of HIV-Associated Dementia The etiologic agents of the neurologic disease associated with HIV and AIDS are many. Opportunistic infections- cryptococcus, toxoplasmosis, cytomegalovirus, are a few of the organic causes of neurologic disease in AIDS patients, but will not be the main focus of this paper. The human immunodeficiency virus in itself is implicated in much of the neurological manifestations of the disease, and it is the effects of the presence of the virus within the central nervous system which is of interest to me in this paper. With the advent of more effective highly active antiretroviral therapy (HAART) and thus increased life span of people with AIDS, neurological disorders are becoming a hot topic in AIDS research. In the early days of the epidemic, those infected with the virus could only hope to live for a short time before developing the symptoms of full blown AIDS, and death ensued shortly afterwards. The progress made in treatment in the past two decades has prolonged the lives of people with AIDS, to the point where diagnosis is no longer a sign of imminent debilitation and death, but rather an acknowledgement of a possible long road ahead with the aid of drug cocktails. There is also a strong possibility that the HIV infected person may develop HIV associated dementia after years of living with the disease (1). HIV associated dementia (HAD) is comprised of a spectrum of conditions from the mild HIV-1 motor cognitive-motor disorder to severe and debilitating AIDS dementia complex. Symptoms begin with motor slowing (2), and may progress to severe loss of cognitive function, loss of bladder and bowel control, and paraparesis . A classification system has been formulated for HIV associated dementia: Stage 0: Normal Stage 0.5: Subclinical or Equivocal Minimal or equivocal symptoms. Mild (soft) neurological signs. No impairment of work or activities of daily living (ADL). Stage 1: Mild Unequivocal intellectual or motor impairment. Able to do all but the most demanding work or ADL. Stage 2: Moderate Cannot work or perform demanding ADL. Capable of self-care. Ambulatory, but may need a single prop. Stage 3: Severe Major intellectual disability, or Cannot walk unassisted. Stage 4: End-Stage Nearly vegetative. 3. Disease may result from the direct presence of the virus in the central nervous system, toxins released from the virus, the body's immunological responses, or any number of other factors. Studies have found that non physiological levels of cytokines in the brain may have an effect of enhancing replication of HIV 3.