The 'side-effects' of HIV

December is HIV and AIDS awareness month and, while most of us know the basics about this disease, not all of us have heard of the other conditions that might occur alongside HIV. People with HIV are more likely to have other conditions as well. Diseases like diabetes, hypertension or hepatitis C might make sense, but did you know that HIV can also affect the brain?

HIV could cause neurological (brain) damage

For HIV patients, many factors can contribute to brain damage: untreated HIV and ongoing inflammation, high viral loads, low CD4 counts, AIDS-related viral and bacterial infections, living with HIV over a long period, side effects from certain older HIV medication or HIV medication that don’t cross the blood-brain barrier. HIV can cause serious neurological conditions such as dementia or peripheral neuropathy. The term HAND (HIV associated neurological disease) is used to describe the various problems related to thinking, memory and mood, and sometimes physical coordination and function.

What causes HAND?

HIV infection causes inflammation throughout the body. Even when a person is taking HIV medication, low levels of inflammation continue. This can damage different types of tissue and cells, including the immune cells that protect the nerve cells – which make up the brain, spinal cord and rest of the nervous system. When those cells are damaged, the nervous system stops working the way it should.

What are the symptoms of HAND?

With the milder forms of HAND, symptoms may go unnoticed by the person and only the most sensitive tests may be able to detect them. In people with noticeable symptoms, they can include:

  • Difficulty recalling facts, memories or things that you’ve just read or heard
  • Trouble paying attention for stretches of time
  • Difficulty learning new tasks
  • Feelings of sadness, hopelessness or anxiety
  • Slower reflexes
  • Feeling ‘fuzzy headed’

These symptoms, however, could also be caused by problems other than HAND, including cardiovascular disease, infection with hepatitis C, clinical depression, anxiety, and overuse of alcohol or recreational and prescription drugs. Some medications may also cause some of these symptoms.

How is HAND diagnosed?

Most healthcare providers will try to rule out all other causes before settling on a diagnosis of HAND. If HAND is suspected, a diagnosis should be confirmed by a neurological specialist familiar with HIV, who can conduct the necessary tests.

Can HAND be prevented or treated?

While it is not clear yet if HAND can be prevented, there are many factors that can reduce the risk of it developing.

  • Control HIV: Staying undetectable with HIV medication appears to help a great deal. Effective treatment also appears to limit milder forms of HAND. Some HIV drugs can cross the barrier between the brain/spinal cord and the bloodstream and they may help to protect the immune cells in the brain.
  • Treat all other infections that add additional inflammation to your body, such as hepatitis B and C, and chronic kidney and liver disease. Chronic depression, anxiety and other mood disorders are all tied to greater inflammation in the brain. Get help in treating these conditions.
  • Get plenty of physical exercise and stay socially engaged to keep your brain in good shape.
  • Stimulate your mind and consider cognitive rehabilitation therapy.

MediBrief articles are not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare provider

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