2. BACKGROUND
• HIV is a neurotropic virus that directly invades
the brain shortly after infection.
• It replicates in brain macrophages and
microglia causing inflammatory and
neurotoxic host responses.
• May cause cognitive ,behavioral and motor
difficulties.
• Range from mild to severe
3. • 3 categories are
• Asymptomatic neurocognitive impairement
• Mild neurocognitive disoder
• HIV associated dementia(major
neurocognitive disoder)
5. Risk factors
• Older age
• Female gender
• More advanced disease(CD4 <100cells/)
• High plasma HIV RNA (viral load)
• Cormobid conditions(CMV,HS 6 , JC virus)
• History of injection drug use
• History of delirium.
6. • With advent of ART, prevalence of HAD has
declined and MND increased.
• Recent research suggests that
neuroinflammation rather than HIV viral load
in CNS is primarily responsible for cognitive
impairement in HIV-infected individuals.
7. • MND is characterised by mild impairment in
functioe clinicianning
• May escape diagnosis by the clinician.
• Onset and course can vary dramatically.
8. HIV associated Dementia
• Characterised by symptoms of cognition,
motor and behavioural disturbances.
• Progressive slowing of cognitive functions;
• Concentration and attention
• Memory
• New learning
• Sequenquencing and problem solving
• Executive control
9. • Behavioural changes
• Apathy
• Loss of motivation
• Poor energy
• Fatigue
• Social withdrawal