HIV updates

[aztecan]

I just returned home from attending the 2010 Annual New Mexico HIV Update.

It was quite interesting this year, with topics ranging from HIV Neurocognitive Disorders, kidney failure among HIVers, and the effects of HIV-related inflammation.

The doctors at the conference reinforced information earlier discussed here and elsewhere regarding HIV and aging, and treatments that cross the blood brain barrier.

The latter, of course, deals with neurocognitive disorders. The program was presented by Dr. Scott Letendre, with the HIV Neurobehavioral Research Center at the University of California, San Diego.

He is currently researching what many of us here call "brain fog."  He said it appears between 40 and 50 percent of all those with HIV will experience this problem.

Letendre said the HIV doesn't actually infect the neurons of the brain, but rather, HIV-infected monocytes cross the blood-brain barrier, and once inside the brain and central nervous system, the HIV replicates using perivascular macrophages and microglia, which in turn give off neurotoxic molecules. The neurocognitive problem is a result of an increased concentration of glutamate and neurotoxins, which are injuring the neurons of the brain.

It does give me some solace knowing this really exists and isn't a figment of my imagination.

Another very interesting presentation involved the effects of long-term HIV inflammation on the body.

Just as we have been reading, what it boils down to is that, for HIV-negative people 50 may be the new 40, but for those of us with HIV, 50 is the new 60.

It doesn't seem to matter whether the HIV is well controlled with ARV therapy, although having a prolonged period - like many years - of undetectable viral loads may have some affect on this process.

There was a lengthy discussion presented by Dr. Steven Deeks, professor of medicine at the University of California, San Francisco, including what specific mechanisms were causing the inflammation and what might be done to combat it.

Dr. Derek Fine, with the Division of Nephrology, Johns Hopkins University School of Medicine, gave a very interesting presentation on kidney disease in HIV.

One of the many topics he discussed was that kidney disease was not being diagnosed early enough because often there are no overt signs.

There also were presentations on depression, the treatment of people who were not diagnosed until late in the disease and treating adolescents.

It was indeed a day well spent.

HUGS,

Mark

[Hellraiser]

I can't say this is good to hear, but I suppose the devil you know is better the one you don't.

[jkinatl2]

This is both good (read: affirming) and sobering news. Thank you for that, Mark.

[Alain]

It does give me some solace knowing this really exists and isn't a figment of my imagination.

Same here.

Thank you Mark for this and take care.

[GSOgymrat]

Thanks for the update, Mark.

[JJ80909]

As a new poz, thank you for the update. I am learning as much as I can right now.

[tednlou2]

Thanks for the info.  It is a little depressing to hear 50% of us will experience the brain issues.  That is one of the scariest things--to lose cognitive performance.  Having said that, I see so many on these forums who can recall all sorts of information about HIV, studies, etc.  If they are all doing this from memory, it gives me hope that it may not be as bad as I'm thinking. 

It is one of those things many of us will wonder what is HIV related or just getting older.  I know my parents are both around 60 and forget stuff from the past or they try to put the cereal in the refrigerator and the milk in the cabinet.

[aztecan]

Thanks for the info.  It is a little depressing to hear 50% of us will experience the brain issues.  That is one of the scariest things--to lose cognitive performance.  Having said that, I see so many on these forums who can recall all sorts of information about HIV, studies, etc.  If they are all doing this from memory, it gives me hope that it may not be as bad as I'm thinking. 

The degree people suffer from this issue, if suffer is the correct word, varies greatly, from what Dr. Deeks said. Also, this "brain fog" should not be confused with AIDS-related dementia, which is a totally different thing and is not seen very often these days.

Dr. Deeks did present several case studies and, what I found interesting was most of them also had comorbidity factors. In other words, they were also meth addicts, were co-infected with HCV, etc;.

How much being addicted to meth, having Hep C, or some other factor, contributes to this issue remains to be seen.

But, if I were a young, spry gay man, I think I would probably eschew dancing with Tina, etc. It just seems the wise thing to do.

HUGS,

Mark

[BT65]

Interesting Mark.  I would really love to hear more about kidney disease, being also diagnosed with diabetes.  If you remember anything about it, please pm me.  Thanks.

[Boze]

Thank you very much for the update.

Did you get a sense that doctors have a clue how to deal with it?

[Inchlingblue]

But, if I were a young, spry gay man, I think I would probably eschew dancing with Tina, etc. It just seems the wise thing to do.
 

True that, and also, I wouldn't be surprised if poppers have an effect on future "brain fog."

[Billy B]

True that, and also, I wouldn't be surprised if poppers have an effect on future "brain fog."

Not highjacking here, but people still do poppers?
Billy

[Miss Philicia]

I wouldn't be surprised if poppers have an effect on future "brain fog."

::rolls eyes::

[pozniceguy]

Thnx MRK   as one of the more mature (older) guys here I can verify the older + hiv  "fog"...  Dr say he has seen a number of possible cases but has no real  prescription to deal with it,  thinks any real treatment may be more philosophical than medicinal,:  keep active, as healthy as possible  and avoid all the good stuff that makes you lethargic...

Nick