Study finds subtle brain damage in some HIV patients on dr...( y include depression memory loss a sl...),Health

y include depression, memory loss, a slowing of mental and physical response time and sluggishness in limb movement. These symptoms can progress to a severe disorder known as HIV dementia, an advanced stage of neurological damage that, before the advent of antiretroviral drug therapy, afflicted some 20 percent of HIV patients. These patients experienced such symptoms as severe memory loss and cognitive impairment, tremors, hyperactive reflexes, immobility, and loss of speech.

Now that antiretroviral drugs have become widely accessible in the U.S., the prevalence of HIV dementia and other neurological problems associated with HIV have sharply declined. But the drugs do not eliminate the virus: they merely suppress it. And while HIV can make its way through the blood-brain barrier (the body's natural defense mechanism that prevents many blood-borne substances from passing into brain tissue), antiretroviral drugs are largely excluded by the barrier.

Taking the first steps to determine how the virus may be affecting the brains of people taking antiretroviral drugs, Chao and her research team compared 39 people who tested positive for HIV who had been taking antiretroviral drugs for at least three months with 39 control subjects not infected by the virus. The HIV-positive group was further divided into two subgroups: a "virally suppressed" group whose 16 members had no detectable virus in blood samples, and a "viremic" group whose 23 members had substantial virus in blood samples. Whether virally suppressed or viremic, all subjects in these groups were healthy with no symptoms of HIV infection.

Study participants ranged in age from 25 to 57 years. All had from 12 to 20 years of education, and no one with a history of substance abuse or psychiatric or neurological disorders was included in the study. Due to inherent difficulties in determining when HIV infection has taken place, this information was not available for study participants.

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Contact: Liese Greensfelder
lgreensfelder@pubaff.ucsf.edu
415-476-2557
University of California - San Francisco
13-Nov-2003

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