AIDS and Central Nervous System

HIV-Associated Neurocognitive Disorder

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How HIV-Associated Neurocognitive Disorder Affects the Mind as a Person Ages

Year after year, advancements made in the treatment of HIV are helping many to lead longer and healthier lives. As individuals enter their later years, it is important to know what to expect when living with HIV.

Current Standards for Testing
For example, at least one-third of HIV-positive patients will develop what is termed HIV-associated neurocognitive disorder.  The medical community knows of this disorder, and very often tests older adults who are HIV-positive. New information on the cognitive functions of those living with an HIV infection may change how physicians test for the disorder.

Normally, doctors will administer a standard neuropsychology exam. If a patient scores well on this test, he is usually deemed cognitively normal. This standard test seemed to be doing the job—until the matter was further investigated. Researchers examined a group of patients who had passed this test, but then subjected them to different types of testing. The surprising results exposed the need for further probing when looking to diagnose HIV-associated neurocognitive disorder.

What the Research Revealed
Older, HIV-positive adults were asked to perform certain mental tasks on cue. At times, the tasks were changed from one to another. This is where physicians began to notice a lag between healthy participants and those with HIV. This response to switching tasks was significantly slower in the HIV group.

To delve a bit deeper, brain scans were ordered. The scans revealed that the dorsal anterior cingulate cortex was reacting differently in the control group than the HIV-positive one. This area of the human brain is linked to both executive and apathetic deficits. These cognitive impairments may come in under the radar with standard testing.

The Latest Developments
At this time, we have no way to treat the disorder. Efficient testing, however, is still vital to patients, as well as their families and caregivers. Understanding that some functions might come a little slower to HIV-positive individuals during their later years is important for those who interact with them daily. Effective testing and education are the keys.

These studies are recent. More study and research are underway.

AIDS Linked to Lymphoma

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AIDS Linked to Lymphoma: CNS Involvement Is Vital

There are a number of connections between diseases that are well-documented and studied. There are also different systems in the body that seem to bear a connection with different diseases. HIV and AIDS seem to have connections with other diseases and with certain networks in the body. For example, doctors are aware that many who present with HIV or AIDS have a greater risk of developing lymphoma. New research shows that not only is AIDS linked to lymphoma, but that the operation of the central nervous system (CNS) also plays a role. The CNS is apparently closely linked to the lymphomas experienced by those with HIV and AIDS. What does this finding mean for a prognosis?

Researchers found that when a person has AIDS, they are at greater risk for lymphoma with central nervous system involvement. As the name suggests, lymphomas normally attack the lymph nodes. The next most common site, however, is the central nervous system. It appears the prognosis is not much different for HIV patients that present with either of these lymphomas. The study, however, found that when treating for cancer, CNS relapse was nearly 3 times more likely to happen in a person with AIDS. Moreover, because this form of cancer is particularly aggressive, the survival rate tends to be low. The hope is that knowing this link exists will help physicians to earlier detect and more effectively treat the disease. (Most people are probably aware that all forms of cancer are easier to treat the earlier that they are diagnosed).

After close consideration of cases of AIDS linked to lymphoma, it was noted that the majority presented with end-stage cancer. This may indicate that during the original diagnosis the CNS involvement may have been overlooked and, therefore, left untreated. Armed with this new information, doctors expect to be able to identify the disease sooner. Researchers, too, are looking into how the CNS is involved. The hope, of course, is this will lead to better treatment options in the future.

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