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HIV-associated dementia (HAD), also known as AIDS dementia complex (ADC), is a type of dementia directly related to HIV infection. It is a severe neurological disorder that affects individuals with HIV/AIDS and can significantly impact their quality of life.

Etiology

HAD is caused by the direct effects of the HIV virus on the brain. The virus enters the central nervous system (CNS) early in the course of HIV infection and can lead to neuronal damage and subsequent cognitive impairment. The exact mechanisms by which HIV causes neuronal damage are not fully understood, but it is believed to involve a combination of direct neurotoxic effects of the virus and indirect effects due to inflammation and immune activation.

Clinical Presentation

The clinical presentation of HAD can vary widely, but it typically involves a combination of cognitive, motor, and behavioral symptoms. Cognitive symptoms can include memory loss, difficulty concentrating, and slowed thinking. Motor symptoms can include weakness, clumsiness, and balance problems. Behavioral symptoms can include apathy, social withdrawal, and changes in personality.

Diagnosis

Diagnosis of HAD is based on clinical criteria, including the presence of cognitive, motor, and behavioral symptoms, as well as evidence of HIV infection. Neuroimaging studies, such as MRI or CT scan, can be used to rule out other causes of dementia. Neuropsychological testing can also be used to assess the extent of cognitive impairment.

Treatment

Treatment of HAD primarily involves antiretroviral therapy (ART) to control HIV infection. ART has been shown to improve cognitive function in individuals with HAD. In addition to ART, symptomatic treatments can be used to manage specific symptoms, such as medications for depression or physical therapy for motor symptoms.

Prognosis

The prognosis of HAD has improved significantly with the advent of ART. However, even with treatment, some individuals may continue to experience cognitive impairment. The severity of HAD can vary widely, with some individuals experiencing mild symptoms and others experiencing severe dementia.

See Also

• HIV/AIDS
• Dementia
• Antiretroviral therapy

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