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Author Topic: HIV neurocognitive impairment must start HAART- what are symptoms?  (Read 2460 times)

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Offline bimazek

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ok so this is saying that we all get brain damage if we have HIV and could someone please say what are the symptoms of that damage usually, i mean what is it functionally, memory loss, emotional problems, ???


HAART should be started as soon as HIV-related neurocognitive impairment is diagnosed, even in patients with 'high' CD4 cell counts, to stop, as soon as possible, the neurological damage

from front page of this website today.....

In a multivariable Cox model, poor performance on the baseline composite NPZ8 global score was the strongest predictor of persistent neuropsychological deficits, with each one-point decrease tripling the probability of remaining impaired despite long-term HAART.    "We believe that HAART should be started as soon as HIV-related neurocognitive impairment is diagnosed, even in patients with 'high' CD4 cell counts, to stop, as soon as possible, the neurological damage," Dr. Tozzi said. "For patients that are not responding neurologically, the presence of other potentially confounding and treatable conditions that could affect cognition (depression, alcohol or other substance abuse, HIV-related CNS diseases, HCV co-infection) should be re-evaluated."

Offline milker

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Re: HIV neurocognitive impairment must start HAART- what are symptoms?
« Reply #1 on: June 27, 2007, 07:14:48 PM »
HIV can cross the blood brain barrier, and CD4s are not in the brain, so what it says is that if a doctor has an HIV+ patient with good CD4 and viral load from the blood, BUT experiences neurological symptoms, then it could be that HIV is having an effect on the patient's brain despite having good blood counts, and to take this into consideration and offer the patient to start HAART.

The NPZ8 is a standard neurological test to assess neurological damage. The results are also called "z score". You can find more information about neurological tests there:

http://www.dentinstitute.com/document_142.html

Neuropsychologic symptoms are usually extreme agitation, loss of control, speech impairment, dementia, etc.. Not remembering what you ate last night or the name of your aunt's cat is not a concern. A primary physician or an ID doctor would have to refer you to a neurophyschologic evaluation if they suspect something wrong in your behavior.

Milker.
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Offline Brussels28

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Re: HIV neurocognitive impairment must start HAART- what are symptoms?
« Reply #2 on: June 29, 2007, 04:13:00 AM »
Does Facial nerve paralysis relates to this in anyway?
some friend of mine is positive since a year with good blood results (high CD4), but recently he had this facial paralysis, Dr says it might be related to HIV infection ....


Offline Tim Horn

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Re: HIV neurocognitive impairment must start HAART- what are symptoms?
« Reply #3 on: June 29, 2007, 05:56:28 AM »
Bimazek:

Are you talking about this recent study?

Tozzi V et al. Persistence of neuropsychologic deficits despite long-term highly active antiretroviral therapy in patients with HIV-related neurocognitive impairment: Prevalence and risk factors. J Acquir Immune Defic Syndr 2007 Jun 1; 45:174-82.

In short, what the study actually shows -- it does not say that "we all get brain damage if we have HIV" -- is that more than 60% of patients with HIV-related neurocognitive impairment (a more modern term for AIDS-related dementia) at baseline continued to have persistent neuropsychologic deficits while receiving ART. Baseline severity of impairment was identified as the major determinant.

Symptoms of early neurocognitive impairment include:

The symptoms of early dementia include:

*Trouble learning new things
*Difficulty remembering things that happened in the past
*Changes in behavior
*Confusion
*Depression

If dementia progresses, it can cause the following symptoms:

*Speech problems
*Balance problems
*Vision problems
*Problems walking
*Loss of bladder control
*Mania (an exaggerated feeling of well-being) or psychosis (a loss of contact with reality)

Of course, many of these symptoms can have different causes, not just dementia/neurocognitive impairment. Depression, for example, can develop in anyone – not just HIV-positive people with suppressed immune systems. Thus, it is important to discuss any changes in your mood, concentration, or behavior with a healthcare provider to figure out what might be going on.

The bottom line of the study is that antiretroviral therapy may want to be started, sooner than later, by those with symptoms of dementia/neurocognitive impairment.

And Brussels28 -- it sounds to me as if you're describing Bell's palsey, not dementia/neurocognitive impairment. 

Tim Horn

Offline savorthemoments

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Re: HIV neurocognitive impairment must start HAART- what are symptoms?
« Reply #4 on: July 19, 2007, 12:58:43 PM »
Tim - I'm trying to pull up the study you are talking about with out any luck.
Can you give me some more direction?

I'm participating in the NIH cognitive study that is currently taking place (it's a 4 year study).

This area is very new hard to find to much information on....


 


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