Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
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San Francisco Examiner - January 30, 2007
Karl B. Hille,khille@baltimoreexaminer.com
HIV-affected white blood cells can migrate from the blood stream into the brain and cause swelling and neural damage, said Ned Sacktor, M.D., a Johns Hopkins neurologist and senior author of the article published in Neurology on Monday.
Unlike Alzheimer's and stroke-induced dementia, HIV dementia is treatable and potentially reversible with the same antiretroviral medication used to treat the infection, Sacktor said. Treatment can even restore completely normal cognitive function to some of those affected.
"Some patients do very well and get back to near-normal performance. Some patients still have mild cognitive defects," he said.
The international study led by Johns Hopkins suggested the rate of HIV-associated dementia is so high in sub-Saharan Africa it tops Alzheimer's disease and dementia from strokes. Researchers found 31 percent of a small but presumably representative group of HIV-positive patients in Uganda had HIV dementia.
HIV dementia includes memory, learning, behavioral and motor disabilities that interfere with normal daily life and in extreme cases lead to total disability, according to their article.
Though American HIV patients generally get better treatment, 10 percent to 15 percent do develop dementia, Sacktor said.
"We see it quite commonly here, but not in the same proportion we see in Uganda," he said adding it "is an under-recognized condition that needs to be studied and treated."
Of the estimated 40 million worldwide living with HIV, about 27 million live in sub-Saharan Africa, according to a release from Hopkins.
"If the rate we saw in our study translates across sub-Saharan Africa, we're looking at more than 8,000,000 people in this region with HIV dementia," Sacktor's article reports.
Before antiretroviral medications were available in the United States, the U.S. rate of HIV dementia was similar to what was discovered in this study, he said. Only 20 percent of people infected with HIV in the world are getting treatment.
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