have been an array of therapies developed since the rise of the HIV
and AIDS epidemic in the 1980s and 1990s that have allowed
HIV-positive individuals to enjoy a better quality of life and
new research indicated that despite long-term treatment, some
HIV-positive people are at an increased risk for developing cognitive
problems. Simply put, HIV cells have been found in the cerebrospinal
these people, it means a higher chance for cognitive defects.
Researchers noted that despite the finding, it doesn’t mean people
are having problems thinking. It does, though, indicate how serious
HIV really is as a virus in that it can cause other health problems
study involved researchers from three universities – Yale
University, University of North Carolina and the University of
Pittsburg School of Medicine. According to Dr. John Mellors, the
study’s lead author and University of Pittsburg School of Medicine
Chief Division of Infectious Diseases the primary goal was to find
out where HIV hides in the body even with potent treatments.
These Hidden HIV Cells
team analyzed the cerebrospinal fluid of about 70 people who had been
treated for HIV for an average of nine years. The researchers found
that half of the individuals had HIV cells in the spinal fluid.
Around 30 percent of them met the conditions used to define impaired cognition. Only 11 percent of them had no HIV cells in the region but still suffered from cognitive issues.
said the team didn’t believe it would discover the cells in the
brain fluid half of the participants and he was just as surprised to
see the cells linked to poor neurocognitive function.
Langone Health Infectious Disease Specialist Dr. Mark Mulligan said
the study is momentous and leads to further questions that must be
answered if there is ever going to be a cure for HIV and AIDS.
said it expands on the present understanding of HIV in the brain.
is a huge demand in understanding HIV and all its complexities, as
there are roughly 1.1 million people who have the disease with
another one in seven who don’t know they have it.
gay and bisexual men are most at risk for the disease, it’s a
condition that affects anyone regardless of their background or sex.
Transgender people, women and people of color face both economic and
social obstacles in getting treatment for the disease.
there’s been a tremendous amount of change since the height of the
who follow their treatments can have a viral load that’s virtually
undetectable, which means they may not transmit the virus to their
sexual partners who are not HIV positive. Still, a lot of work has
to be done. Since HIV has no cure and, even with the best possible
treatments, the virus remains in the body.
The Brain Affected By HIV?
brain is the one known place of persistence for HIV. Mulligan said
cognitive ability could either be mildly or severely impaired –
dementia, Alzheimer’s disease – when the person isn’t taking
antiviral treatments. And, even with treatments, the changes in
cognition is subtle.
According to Mulligan, this may be the result of several factors such as the virus directly affecting the brain cells or the indirect nature such as inflammation damaging the brain cells, a compromised immune system and other co-existing issues.
said HIV cognition problems are significant but are not as frequent
and severe in today’s form of treatments. Still, he said, more
research on brain health is needed to improve the brain health of
those infected with HIV.
said research for a cure would need to involve total eradication of
HIV in the body including the brain where it can hide even in
individuals with s long-term treatment.
said the biggest point people should take from the research is that
HIV can lead to brain dysfunction even with the best treatments being
used even though it’s not known how HIV in the spinal fluid is
causing the problem. Mulligan said more work must be done to
determine the cause and effect.
team is still looking at the kind of HIV cells that are in the fluid;
if it’s infectious and tearing them apart to determine the
relationship between the cognitive decline and infected cells.
Anyone with HIV or know someone with HIV should talk to their doctor and an HIV specialist about the possibility of cognitive decline. The doctor will need to take a thorough medical history, do a physical exam, send off for blood tests and order brain scan images. They may even suggest a spinal tap to see what the cerebrospinal fluid reveals.