AIDS dementia

Background

  • Also referred to as HIV encephalopathy
  • Progressive disorder heralded by impairment of recent memory and other cognitive deficits
  • Occurs in 10-15% of HIV+ patients; 30% of patients with CD4 <100
  • Diagnosis of exclusion

Clinical Features

  • Can initially be confused with depression, anxiety disorders, or substance abuse
  • Changes in mental status
  • Aphasia
  • Motor abnormalities. Patients with an established diagnosis of AIDS dementia who develop progressive neurologic or psychologic signs or symptoms warrant further evaluation for systemic or CNS processes

Differential Diagnosis

Altered mental status

Diffuse brain dysfunction

Primary CNS disease or trauma

Psychiatric

HIV associated conditions

Evaluation

  • Head CT shows cortical atrophy and ventricular enlargement
  • Associated with elevated CSF protein in 50-70% of cases

Management

See Also

References

  1. Gutteridge, David L MD, MPH, Egan, Daniel J. MD. The HIV-Infected Adult Patient in The Emergency Department: The Changing Landscape of the Disease. Emergency Medicine Practice: An Evidence-Based Approach to Emergency Medicine. Vol 18, Num 2. Feb 2016.

Authors:

Ross Donaldson