Nervous System Problems With HIV

Today's post from nurseuncut.com.au (see link below) looks at other central nervous system abnormalities associated with HIV other than neuropathy. You shouldn't really be as afraid of HIV-related dementia anymore; the numbers being recorded are very low indeed but many of us will notice a degree of cognitive impairment that may well be HIV-related. If you already have neuropathy to deal with, you may make the link between the two but a discussion with your specialist should set your mind at rest. Nevertheless, the longer people live with HIV, the older they get and by definition, the more likely they are to suffer some form of cognitive impairment anyway. It's difficult to pin the cause down to one thing or the other. We need to talk to our doctors to establish what things are age-related and what things are HIV-related and yes, maybe some forms of cognitive behaviour may be related to both but as doctors themselves become more aware that long-term HIV patients may be susceptible to these problems, they will be able to make better objective diagnoses.

Positive living with HIV
Guest post by Adrian Ogier, the editor of Positive Living, published by the National Association of People with HIV Australia (NAPWHA). Posted on December 12, 2012 by NU_admin 

Here, Adrian introduces the current issue of Positive Living.

A lot of people with HIV worry about losing our minds—particularly those of us who’ve had HIV for a while and are, how shall I put it, getting on in years…

We remember the toll paid before decent HIV treatments came along. Early in the epidemic about one in seven people with AIDS developed dementia, a diagnosis that usually progressed to severe disability and death within a year.

But there’s no need for panic. HIV-associated dementia is now so rare that the incidence is down to almost zero.

What we are seeing these days, however, is quite a bit of low-level neurocognitive impairment. Some of it is so low level, in fact, that while it can be picked up by a range of neuropsychological tests, the person with HIV and their significant others don’t even know anything is going on.

Up to 50 percent of people with HIV who are on treatment may be living with central nervous system abnormalities. Most of these are mild and include things like peripheral neuropathy, myopathy (limb muscle weakness, myalgia and muscle cramps) and changes in brain structure and functioning.

HIV gets into the central nervous system (CNS) quite early on – often within a week of infection. Over time it can cause an immune response, inflammation and the production of chemicals (cytokines and chemokines). All this may result in damage to a range of cells, particularly in the brain.

For some people on treatment, HIV still seems able to affect those parts of the brain related to cognitive ability, including memory, learning, attention and how fast we process things. The problem is that these losses are similar to those everyone experiences in older age. This intersection between ageing and HIV in the brain, together with a range of other factors, can make it difficult to untangle the relative contribution of each.

In the December issue of Positive Living, Neil McKellar-Stewart looks at HIV in the central nervous system and explains why taking treatment and a range of other health measures is so important for keeping our brains healthy. We also list some of the commonly-used HIV treatments in Australia and rate them according to their ability to penetrate the blood-brain barrier.

We also tackle ways we can monitor our alcohol and drug intake. This is the time of year when many of us start to rev up our intake. Kurt Andersson-Noorgard, a clinical nurse consultant at St Vincent’s Hospital, suggests steps we can take to look at and then change our patterns of use.

http://www.nurseuncut.com.au/positive-living-with-hiv/