Cognitive effects of HIV and HIV treatment

[nxt1001]

I'm worried about the cognitive side effects of many HIV treatments and HIV associated neurocognitive decline. I've already noticed since starting triumeq that I can't concentrate as well as I used to. I find myself getting distracted at work, or my thoughts wandering when trying to read. I also seem to zone out more often. I've been reading about the side effects of many HIV drugs. Pretty much all of them can cause "brain fog" type symptoms and exacerbate preexisting depression. I've also been reading about neurocognitive effects of the virus itself. About half of all HIV patients develop neurocogitive disorder. It can range from a decrease in cognitive/learning ability to a noticeable effect on daily life to even full on dementia.

My career requires me to keep a sharp mind. If my cognitive abilities start declining now, I'm going to be stuck in lower level positions the rest of my life. I also used to enjoy reading and learning new things, but I can already feel a slight loss of interest and ability in those things. I feel like I've been taking xanax every day (without the benefit of being less anxious). Maybe that's just worsening depression or temporary side effects of the new meds, but I'm still worried about early mental decline from the virus itself. I don't want to end up as a 30 year old with noticeably deteriorating mental ability.

[90szeitgeist]

As for the 'Half of all HIV patients develop neurocognitive disorder' - the test is probably way too sensitive. I remember reading several studies where the same test was being applied to the general (gay) population and the % of neurocognitive disorder was only slightly lower.

That being said, brain imaging have shown HIV to age the brain between 15-20 years, even with succesful treatment. I read a more recent study with brain imaging as well, where it showed that positive people who exercised regularly had a brain that was 10 year younger than their non-exercising positive counterparts. So it is possible to mitigate some of the damage through exercise. Creatine has also shown some effect in protecting the brain and so has anti-inflammatory food. Stay away from alcohol, drugs and smoking. Depression also rapidly ages your brain . You have to work harder to stay young in body and mind. HIV and aging in general brings forth neurocognitive decline - it is something we just have to accept.

Sorry for not linking said studies - some of them I've encountered on this forum.

[red_Dragon888]

some meds will have serious effects on the brain and others will have little to no effects.  find the combo that works best for you.

[harleymc]

Losing interest in things, or getting distracted doesn't sound anything like brain fog. That sounds like a mind that is engaged elsewhere.

As to the 50% statistic of positive people having some form of neurocognitive deficit, the very same tests show  a high percentage of matched HIV negative controls have neurocognitive deficit.
As a group we're only marginally different from the HIV negative population.

[BT65]

Nxt, I'm going to be frank here.  What it sounds like to me is depression.  I have not read through your other posts, but I know a lot of us in the HIV+ population do have depression.  I don't know your story but I'm assuming you're not a long term survivor, which means you were diagnosed prior to 1996, when the newer meds started saving lives. I believe cognitive decline happens mostly in the population who are long term survivors. 

I like to learn new things also.  I would suggest taking a class at an accredited college.  I myself am a long term survivor, diagnosed in the late '80's, but a few years back got my undergrad in psychology.  I can tell you I enjoyed college immensely and it helped my self esteem to learn new things.  I also went through a master's program but when I started to write my thesis I fell and broke my hip, so that ended that (for now lol). 

I love to read also.  I do have periods when concentrating is more difficult than other times, and it's usually when I have something going on in my life that really does need my attention. I just have to figure out what that is, because feelings will come out cross ways and the misinterpretation can cause confusion. 

I would suggest seeing a therapist.  There's nothing wrong with that.  I would be screened for any underlying depression that may be going on and then get it treated.  I went to therapy for quite a while and plan on going back here soon because of some situations that have come up that I don't know how to "Fix" on m own.  Seriously, please do seek help. 

Good luck and I hope to read more from you!

Betty

[CaveyUK]

Just to echo stuff already said really.

Studies into cognitive decline don't show a massive difference from the neg population, and will usually be factoring in people who have been on drugs for many years, often before the medications became refined and had more serious side effects.

Secondly there are many people in positions of great authority who have HIV and are on treatment. In the UK, we have members of parliament in that situation, and until recently the chairman of one of the countries largest environment agencies was living with HIV. And they are the obvious 'out' people I can think of. One of the effects of HIV treatment being so good these days are that people in high ranking positions or the public eye no longer feel the need to discuss it openly.

I am not in 'great authority' but do have a senior role in a major company to which I need to be alert, keep a sharp mind and face-off to senior executives. I don't experience any noticeable 'brain fog' on my particular regimen, although it was a reason I elected (with my doc) not to start on a particular drug combo (Atripla).

Wandering mind sounds more of an effect of being stressed and/or depressed and having things weighing heavily on you. I doubt very much it is anything specifc to do with your medication or your HIV.

[mecch]

In my opinion which is not medical nor expert - just what I've seen frequently around the forum for years - 30 years old is young to have cognitive effects of HIV TREATMENT.   How long have you been treated?

It sounds like a good time to have talks with the doctor who is treating your HIV, as well as your GP - if its not the same person. And perhaps a psychiatrist. 

[Will1767]

Thank you nxt1001 for posting the question.  I have been on treatment for two months (triumeq).  I too feel like my cognative functions are somehow impaired.  I manage a corporation, and also am paid for my brain power.  So it has become a worry of mine too.  I have written this down to ask my ID doctor on next visit.  I think after reading all these respones, that stress and depression related to the virus, might be part of it. So I plan to see a pshycologist.  --Will

[heretolearn]

I really do think that seroconversion caused some mental issues for me for a while but now that I am healthy again I feel like I am back to normal.

I was reading about how thc passes the blood brain barrier and suppresses the immune system in such a way that protects the brain from damage caused by hiv.

Just Google "hiv thc cb2 receptor". It is pretty interesting.

[aki-pk]

I am hiv +ve from Pakistan where discussion on this topic is almost nil. I am very much depressed and there is no forum to discuss issues facing due to my treatment except my doctor. I am on treatment (Efavirenz,Lamivudine &Tenofovir disoproxil fumarate 600+600+300mg) one pill per day since 30th March 2016 i.e.19days have been passed and I remained under great depression,weakness and tired all the time. I start weeping loudly and sometimes just want death instead of life. So I requested my doctor to reconsider my medicine. Now he is changing medicine from tonight. I do not know what will be the effect of new regimen. I am being treated from Shukat Khanum Hospital Lahore. Is there anyone from pakistan to share his views. My CD4 on 17th March 2016 was 359,viral load not tested.
My brain seems foggy and I feel dizziness.Said medicine seems bad effect on brain. Is someone here from Pakistan?

[irdo123]

Hi all,

I think I can calm all of you down a little.

I have severe ADD and tend to get depressed from time to time (was depressed 5 year straight which successfully got treated by therapy and wellbutrin).

I got HIV in december 2013 but didnīt get the diagnosise until 2015 april. When I tested positive in april 2015 the doctor analyzed one of my old blood samples, that was used to syphilis testing, from early january 2014 and saw that I actually had HIV already but it just didnīt come up on the fast test. Which indicates that I got it around december 2013 which fits.

I did not feel good during that period (in the beginning of 2014) so I made enormous life changes. Started working out like crazy and got on a really good diet (didnīt know what was wrong with me).. I started running for at least 15 hours per week. Did feel a little bit better because of this but I noticed I was not able to function in school for the whole year 2014, I failed everything. I felt like I was 80 years old cognitively and got more and more depressed... Didnīt know what the fuck was up with me. Iīm the kind of person that just adapts to every circumstance, turn of my emotion and I just accept the circumstance in 2 minutes time. Therefore I just tried to make the best of it by keep on excercising and eating a very healthy diet.

And then, in april 2015 as I said, I got diagnosed with HIV. I had a viral load of 7000 and CD4 around 450. I had felt terrible for a long time, especially my mental abilities that was totally lost. In may I started treatment with complera. Gradually I started to notice subtle changes in my mental energy levels. And now, over one year later, I feel totally recovered and back to normal again. I feel very good. Iīm only 28 years old but during year 2014 I actuelly felt like I was at lest 80 years old, Itīs almost like I noticed that I was moving closer and closer to death as well, without me knowing what it was.

So what is the point of my post? In my case I went from being a 26 year old that felt like he was at least 85 year old with some signs of dementia to a 28 year old that feel like he is maybe around 22 year old.

I feel very healthy cognitively and physical. I work on it of course, by doing a lot of excercise and eating decent food but my constitution is a lot better now than it was a couple of years ago. I feel wonderful and happy.

Donīt give up, keep on working on your mental health and physical health by treating depression, working out (important to find something you donīt hate), eating balanced and sleeping well. Try to have some near sighted goals in life and find what you want to do and what people you want to be around. Donīt do what other people want you to do, try to do what you want to do.

Good luck