[Dementia associated with AIDS]

Dementia associated with AIDS or AIDS dementia complex (ADC) is characterized by neurocognitive defects with disorders of the functional ability of the patient for work and the activities of everyday life. The increasing number of AIDS patients has led to a significant rise in those with neurological involvement, especially in poorer countries.

At present no data on the incidence of ADC is available. The prevalence varies with the population studied and criteria used for diagnosis. Some authors have suggested a frequency of 8 to 16%. However, other reports mention an incidence of up to 20.7% of encephalopathy in AIDS patients. The mechanism by which ADC occurs is still not clear. Many factors have been suggested but none confirmed as causal.

symptoms are due to subcortical dementia with difficulty in concentration, memory and learning whilst language, recognition, basic attention and executive function are relatively well preserved.

this is essentially clinical, by exclusion, in cases of HIV+ patients with marked immunological deterioration and compatible clinical features.

current clinical guidelines recommend that most AIDS/HIV patients, if not all, should receive treatment with potent combinations of anti retroviral drugs.

Even in the age of modern, highly active anti retroviral treatment, ADC is still a devastating complication of HIV infection.