Hi Dr. Feinberg,I have an AIDS diagnosis and have probably been infected since the mid-eighties. My last t-cell count was 147 with a VL of 158,000. This was off of meds (treatment interuption). In addition, I have been informed that I have multiple cross resistance to most meds and the ones that I do not have resistance to I can't take because of terrible side effects. Over these last couple of years I have noticed that I am much more forgetful. I often lose my train of thought when speaking, which is embarrasing. Sometimes I can't recall trivial information such as an actor that appeared in a movie I just saw. I can't tell you how many times I have had to search parking lots because I forgot where I parked. I have had some neurological testing done and it did reveal some problems with memory and such. I was informed by the doctor that what I am experiencing is very common to people with HIV/AIDS. Especially so with those individuals who have been infected for long periods of time. That, of course did not make me feel better. I feel like an old person at 40! Is this going to get worse like an Alzheimers patient or does this manifestation of HIV/AIDS stay kind of where it is? Do you have any suggestions on how I might deal with this very frustrating problem? Also, you should know that I just recently started back on meds (epivir, viread, abacavir).

It sounds like you have some loss of brain tissue ("atrophy") that is associated with long-standing HIV infection ("AIDS dementia" of "HIV encephalopathy"). The best way to improve memory and thought processes is to get your HIV infection under control. Some people benfit from Ritalin and similar agents used for ADHD in children.

Since you mentioned that you have acquired a lot of resistance to HIV drugs, I am concerned that you are on 3TC (Epivir) and abacavir (Ziagen). These 2 drugs have some cross-resistance, and 3TC resistance is extraordinarily easy to develop and therefore very common. Did your doctor do a resistance test to help choose your new combination? If not, you may want to talk to him/her about it, as you need the best shot at virologic control that you can get if your brain is going to function better. Good luck!