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Is there any help with aids dementia?
Mar 24, 2003

My friend has full blown Aids with an off the board viral count and T-cells at 3. He has been off meds for nearly two years, since he developed resistance to everything available at that time. Now, they are still waiting for a cocktail of 3 before starting a new regimen. His dementia is increasing steadily. Mostly in the form of forgetfullness and covering up. Should he consider an individual med or clinical trial at this time? Will it stop or reverse the demential? Three years ago they said he had a considerable amount of calcification on his brain. What are our options and what can I do to help him manage? With sincere thanks, LT

Response from Dr. Horwath

The best treatment for HIV-associated dementia is an effective anti-retroviral cocktail. It is clear from several studies that keeping the viral load low is strongly associated with fewer neuropsychological symptoms and a lower risk of HIV-associated dementia. In my own clinical practice, I have seen substantial improvement, even in patients with severe dementia, after they were placed on an effective anti-retroviral cocktail and had other medical complications treated.

While searching for an effective HAART regimen, your friend can be helped by structuring his environment, using cues to help him remember things (little post-it notes can be useful reminders), and making someone available to assist him in daily routines. He should also have a psychiatric evaluation to make sure that dementia is the right diagnosis, and to see if he is suffering from another psychiatric disorder, which may be treatable.



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