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Brain dudes!!!!
Nov 4, 2005

Dear gerald

>The other day y learnt in a spanish paper one nwes about the problem of the HIV progress in thos orgam....the news says abot the no work HART terapy in this part of the body!!!! im stay sqare!!!

Questions: 1.- Now we can live 20m years ( for example) but the problem is , in all of cas our brain is go down? 20 years but "down"....

2.- Whats your opinion bout the development of new drugs to try to work in this area???

3.- What do you think about the therapeutic vacunes for hiv...10 years? 20 years??? never????

Sorry for my english!!!!!!!

Saludos desde Buenpos Aires

Response from Dr. Pierone

This recent publication received a lot of media attention and I can add my comments from the peanut gallery. First, there is no question that some patients with AIDS have loss of brain structure and function. In general, the lower the CD4 count, the worse the brain function. Another observation is that brain function is worse in AIDS patients who are not on antiretroviral therapy. This study showed a 15% reduction in the size of some of the cortical (grey matter) areas of the brain in 26 subjects with AIDS compared to 14 non HIV-infected controls. Ok, this is the bad news.

Here is the good news. In cases of AIDS dementia, it is usual to see dramatic improvement of cognitive function after initiation of HAART. Moreover, most people living with AIDS on therapy have no discernable signs of cognitive dysfunction or mental impairment. In the real world we are simply not seeing patients with AIDS and controlled viral replication developing dementia.

I think that newer antiretroviral agents will be more potent and some of them will also be targeted to the central nervous system.

Finally, I think that therapeutic vaccines will be the primary means by which we treat HIV infection in 10 years and that antiretroviral therapy will how we manage vaccine non-responders. Thanks for posting and stay tuned!



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