Neurological Complications of AIDS
AIDS is primarily an immune system disorder caused by the human immunodeficiency virus (HIV), but it can also affect the nervous system. HIV does not appear to directly invade nerve cells but it jeopardizes their health and function, causing symptoms such as confusion, forgetfulness, behavioral changes, headaches, progressive weakness and loss of sensation in the arms and legs, cognitive motor impairment, or damage to the peripheral nerves. Other complications that can occur as a result of HIV infection or the drugs used to treat it include pain, seizures, shingles, spinal cord problems, lack of coordination, difficult or painful swallowing, anxiety disorder, depression, fever, vision loss, gait disorders, destruction of brain tissue, and coma. Other AIDS-related nervous system disorders may be caused by certain cancers or by illnesses that would not otherwise affect people with healthy immune systems.Among the most common neurological complications are: AIDS dementia complex, causing symptoms such as encephalitis (inflammation of the brain), behavioral changes, and a gradual decline in cognitive function; central nervous system lymphomas, cancerous tumors that either begin in the brain or result from a cancer that has spread from another site in the body; cryptococcal meningitis; cytomegalovirus infections; herpes virus infections; neuropathy; neurosyphilis; progressive multifocal leukoencephalopathy (PML); and psychological and neuropsychiatric disorders.
No single treatment can cure the neurological complications of AIDS. Some disorders require aggressive therapy while others are treated symptomatically.Medicines range from analgesics sold over the counter to antiepileptic drugs, opiates, corticosteroids, and some classes of antidepressants. Other treatments include radiation therapy or chemotherapy to kill or shrink cancerous brain tumors that may be caused by HIV, antifungal or antimalarial drugs to combat certain bacterial infections, and penicillin to treat neurosyphilis. Aggressive antiretroviral therapy is used to treat AIDS dementia complex, PML, and cytomegalovirus encephalitis. HAART, or highly active antiretroviral therapy, combines at least three drugs to reduce the amount of virus circulating in the blood and may also delay the start of some infections.
The overall prognosis for individuals with AIDS in recent years has improved significantly because of new drugs and treatments. AIDS clinicians often fail to recognize neurological complications of AIDS. Those who suspect they are having neurological complications should be sure to discuss these with their doctor.
Within the Federal government, the National Institute of Neurological Disorders and Stroke (NINDS), one part of the National Institutes of Health (NIH), supports research on the neurological consequences of AIDS. The NINDS works closely with its sister agency, the National Institute of Allergy and Infectious Diseases (NIAID), which has primary responsibility for research related to HIV and AIDS.
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Neurologic AIDS Research Consortium
The Neurologic AIDS Research Consortium (NARC) is supported by the National Institutes of Health to design and carry out clinical trials to improve the therapy for HIV induced neurologic disease, and neurologic conditions associated with the AIDS virus. This consortium was established in 1993 when the NARC grant submitted by David B. Clifford, M.D. of Washington University School of Medicine was funded by the National Institute of Neurologic Disorders and Stroke (NINDS) to establish the consortium. Since that time the grant has supported studies of the natural history of neurologic performance in advanced AIDS, treatment of HIV associated peripheral neuropathy, progressive multifocal leukoencephalopathy, and cytomegalovirus.
Department of Neurology
Washington School of Medicine
Campus Box 8111
660 S. Euclid Avenue
St. Louis, MO 63110
Elizabeth Glaser Pediatric AIDS Foundation
Sponsors research programs, collaborative training initiatives, advocacy efforts, and international programs focused on pediatric AIDS and other serious and life-threatening diseases affecting children.
1140 Connecticut Avenue, NW
Washington, DC 20036
amfAR, The Foundation for AIDS Research
Non-profit organization dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy.
120 Wall Street
New York, NY 10005-3908
National Association of People with AIDS
Advocates on behalf of all people living with HIV and AIDS.
8401 Colesville Road
Silver Spring, MD 20910
Tel: 240-247-0880 or 866-846-9366
National NeuroAIDS Tissue Consortium
Provides tissue for AIDS-related research through a banking network of centers.
401 N. Washington Street
Rockville, MD 20850
301-251-1161 ext. 186
National Prevention Information Network
Centers for Disease Control and Prevention, DHHS
P.O. Box 6003
Rockville, MD 20849-6003
National Institute of Allergy and Infectious
National Institutes of Health, DHHS
6610 Rockledge Drive, MSC 6612
Bethesda, MD 20892-6612
AIDSInfo (AIDS Information Service)
P.O. Box 6303
Rockville, MD 20849-6303