Home > Diagnosis, Types of dementia > What is AIDS Dementia Complex?

What is AIDS Dementia Complex?

AIDS Dementia Complex (ADC) is a neurological condition that can occur in the latter stages of AIDS, or Acquired Immunodeficiency Syndrome.  It is also known as HIV Dementia, HIV Encephalopathy, HIV-associated Dementia, and HIV-associated Neurocognitive Disorder.  Today, only about 10 to 15% of people who get AIDS develop ADC, thanks to recent medical advances.

Many people infected with HIV develop opportunistic infections, because of their weakened immune systems.  However, it is commonly believed that ADC comes directly from the HIV infection, as the virus indirectly kills brain cells.  The areas of brain function that are generally infected include thinking ability, behavior, coordination and movement, and mood.

ADC is difficult to diagnose because its symptoms can resemble other HIV-related problems such as opportunistic infections and reactions to medications.  Some of the first signs of ADC include:

  1.  Short attention span
  2. Memory loss
  3. Poor judgment
  4. Increased time required for mental processing and completion of tasks
  5. Irritability
  6. Problems with gait and balance
  7. Poor hand coordination and tremor
  8. Depression and social withdrawal

Progression of ADC may be fast or slow, as the symptoms will be different from person to person.  As the disease progresses, the individual may experience drastic mood swings, psychosis, and loss of bladder and bowel control.  Eventually, the disease is often (but not always) fatal.

Diagnostic criteria for ADC are as follows:

  1.  Development of significant impairment in at least two areas of cognitive functioning (for example, attention, information processing, memory), as identified by medical history, mental status testing, or neuropsychological testing.
  2. These impairments should significantly interfere with day-to-day functioning.
  3. They should be present for more than one month.
  4. They do not meet the criteria for delirium.
  5. There is no other pre-existing condition that could account for the symptoms.

As with other forms of dementia, diagnosis of ADC will involve making sure that a person doesn’t have another condition that may produce similar symptoms.  This is complicated still further by the fact that more than one HIV-related disorder can cause the same symptoms.  Some tests that the doctor might order include a mental status exam, brain imaging, and spinal tap.

The best treatment for ADC is through the administration of Highly Active Anti-retroviral Therapy (HAART), an aggressive series of treatment protocols used to suppress HIV viral replication and progression of disease processes.  It may actually improve mental function in a person who already has ADC, or may delay its onset in others.  The goal of treatment is not just remediation of the ADC, but eradication of the virus altogether.  Note that a person whose memory has already been affected by the disease may need to have help remembering to take his medication.  The specific medications used will be decided upon by the infected person and his/her doctor, and may need to be modified based on individual symptoms and reactions.  There are other medications that may be prescribed to help alleviate the symptoms of ADC, such as drugs to control depression, lack of energy, anxiety, appetite, concentration, and agitation.

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