AIDS dementia complex (ADC) can occur in people with
AIDS. ADC results in changes in multiple neurologic areas:
Cognition—the ability to understand, process, and remember informationBehavior—difficulty performing daily tasks
Emotions—may have personality changes and
depressionMotor coordination—the ability to coordinate muscles and movement
ADC is a common nervous system complication of late-stage HIV infection.
HIV destroys white blood cells vital to the immune system.
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It is not clearly understood how HIV infection causes ADC.
Factors that may increase your chance of having ADC include: Untreated HIV infectionLate-stage AIDS
Symptoms usually develop slowly and worsen over time. They can be grouped into stages:
Difficulty concentratingDifficulty remembering details, such as phone numbers, appointments, or tracking daily activitiesSlowed thinkingLonger time needed to complete complicated tasksIrritabilityUnsteady walking, tremor, or difficulty keeping balancePoor hand functionChange in handwritingDepression
WeaknessMore focus and attention neededSlow responsesFrequently dropping objectsFeelings of indifference or apathySlowness or difficulty with normal activities, such as eating or writing
Walking, balance, and coordination require a great deal of effort at this stage.
Loss of bladder or bowel controlAbnormal gait, making walking more difficultMutenessWithdrawing from lifeSevere mental disorders, such as psychosis or maniaUnable to leave bed
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include: HIV testMental status/neurological examMRI scan
CT scanLumbar puncture
to check cerebrospinal fluid in the spinal cord and brain
(EEG) to check the brain's electrical activity
Talk with your doctor about the best treatment plan for you. Treatment options include:
Anti-HIV drugs are often used to treat ADC. Your doctor will create a medication plan that is right for you. These drugs are often given in combination.
Other medications may be used along with antiretroviral therapy to treat symptoms of ADC. These may include: AntipsychoticsAntidepressantsAnti-anxiety medicationsStimulantsMood stabilizersMedications to prevent seizures
ADC occurs in people with HIV. Ways to help reduce your chance of getting HIV include:
When you have sex, use a male latex
Limit your number of sexual partners.Avoid sexual partners who are HIV-infected.Do not share needles for drug injection.Avoid having transfusions of blood products that have not been screened.
If you are a healthcare worker:
Wear appropriate gloves and facial masks during all procedures.Carefully handle and properly dispose of needles.Carefully follow universal precautions.
If you live in a household with someone who has HIV:
Wear appropriate gloves if handling HIV-infected bodily fluids.Cover your cuts and sores with bandages. Also cover cuts and sores on the person with HIV.Do not share any personal hygiene items, such as razors or toothbrushes.Carefully handle and properly dispose of needles used for medication.
AIDS dementia complex. University of California at San Francisco website. Available at:
http://hivinsite.ucsf.edu/InSite?page=id-01-08. Accessed September 4 ,2013.
HIV-associated dementia. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed.ebscohost.com/about/about-us. Updated March 7, 2013. Accessed September 4, 2013.
Luo X, Carlson KA, et al. Macrophage proteomic fingerprinting predicts HIV-1-associated cognitive impairment.
Meehan RA, Brush JA. An overview of AIDS dementia complex.
Am J Alzheimers Dis Other Demen.
Nicholas MK, Lukas R, et al.
Textbook of Neurological Surgery.
6th ed. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2011: chap 46.
Last reviewed September 2013 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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