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May 27, 2004

I was just diagnosed with havin dimentia.Although I have an undetectable viral load and a tcell count of over 700. I believe that the virus attacked my brain and cns early on before treatment began and did the damage at that time. 1= Is the dementia active and degenerative? 2=Is there medication for this? 3=I had an mri without dye,and have not had a spinal tap is this neccessary? 4=How long do I have before I am totaly disabled? Presently I have very low memory retainance and motor skills. I am also Bipolar and ocd and add.... What are your thoughts on my condition. I am seeing 2 doctors a Psychiatrist and a therapist with my partner to cope with this......... what are my next steps? PLEASE HELPPPPPPPPPPPPPPPPPPPPPP

Response from Dr. Horwath

You didn't mention which antiretroviral treatment you are taking. Your regimen must be effective since you have an undetectable viral load and high T cell count. However, some of the antiretroviral drugs do not have good penetration into the central nervous system (CNS). You may want to discuss with your doctor whether you are a candidtate to switch to antiretrvirals that are better able to get into the CNS. These drugs include AZT, lamivudine, stavudine, nevirapine and indinavir. This is one factor that might go into choosing a regimen and is worth discussing with your doctor.

Some people develop cognitive symptoms even with a low viral load and high T cells. We do not fully understand all the factors involved. But the fact that you have some memory problems now does not necessarily mean that these symptoms will progress. Continue your treatment and discuss the options with your doctor. It is not necessary to get a spinal tap.

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