Timely Topics in Clinical Immunology

HIV Dementia Scale Review Articles

HIV encephalopathy is an infection that spreads throughout the brain. It is one explanation for dementia in people infected with HIV. The greater the spread of infection within the brain, the more severe the dementia symptoms become. AIDS dementia is additionally called AIDS dementia complex or HIV-associated dementia.

Purely HIV-associated dementia is caused by neuronal damage by the HIV virus. However, in patients with HIV infection, dementia may result from other disorders, a number of which can be treatable. These disorders include other infections, such as secondary infection with JC virus causing progressive multifocal leukoencephalopathy and central nervous system; lymphoma. Other opportunistic infections (eg, cryptococcal meningitis, other fungal meningitis, some bacterial infections, tuberculosis meningitis, viral infections, toxoplasmosis) may also contribute.

In purely HIV-associated dementia, subcortical pathologic changes result when infected macrophages or microglial cells infiltrate into the deep grey matter (ie, basal ganglia, thalamus) and substantia alba.

Prevalence of dementia in late-stage HIV infection ranges from 7 to 27%, but 30 to 40% may have milder forms. Incidence is inversely proportional to CD4 count.

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