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Ask the Experts about Mental Health and HIV
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HIV Dementia
Jan 11, 2009

I have been HIV+ for 19 years and have been undetected for the last 8 years. I recently was diagnosed with HIV dementia. My viral load is <60 and my t cell count 660. I am on Viread and Epzicom for the last 8 years. Do I need to have my meds changed? Can I recover for HIV dementia? the neuropshyc evaluation stated I will not be able to work in my previous employment due to lack of concentration and analysis and thorough thinking

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   Response from Dr. Horwath

Unfortunately, some people develop symptoms of HIV dementia even with undetectable viral load and adequate T-cells. There is not much evidence that some antiretrovirals are better than others for HIV dementia.

However, there is a debate in the field as to whether the drugs that penetrate the blood brain barrier might be more effective in preventing and treating HIV dementia. In general, the protease inhibitors have poor penetration into the central nervous system (CNS). The NNRTIs and NRTIs have much better penetrance. Zidovudine (AZT, ZDV) has the best penetrance into the CNS. You may wish to discuss these options with your doctor.



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