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Am I losing my memory due to HIV?
May 22, 2010

I am 47 years old and have forgotten my social security number twice. I forget a lot of things. My mom who is 80 remembers everything. I have been poz for 17 years. Am I losing my memory? What can I do about it, Nelson? Do you have this problem? My T cells are 300 and my viral load has been undectable for 5 years. I had PCP 10 years ago and was very sick but I am good now.

Steve

Response from Mr. Vergel

Steve

I know the feeling! Sometimes I do not know if my memory problems are due to HIV or aging.

The CHARTER study looked into functions such as learning, remembering, planning, making decisions, attentional abilities and concentration in 1600 HIV+ patients. The average age of participants was 47. More than half had normal cognitive function. The study found that those who had low CD4 cells in their HIV infection in the past and older age to be the two main factors that correlated to lower cognitive function. Surprisingly, current viral load and CD4 cells did not show any correlation. It seems that when people reach a very low level of CD4 cells, something changes that may or may not be able to be reversed even after HIV medications improve CD4 counts. But these findings are preliminary and speculative at this point.

Some doctors are prescribing ADHD drugs like Ritalin or Adderall off label to patients with memory or focus problems. But we really have no data to support that use. Some researchers are exploring using the antibiotic Minocycline for cognitive improvements since in monkey studies, minocycline suppressed viral load in the brain, and decreased the expression of Central Nervous System (CNS) inflammatory markers. Studies in humans are now being performed.

The use of HIV medications that better penetrate the blood brain barrier to improve cognitive function has not been validated in studies ( except for early studies using AZT monotherapy in the 80's-90's). Actually, there is debate now about the fact that some of those drugs may also be the most neurotoxic. So, as you can tell, this area of research is an expanding one full of questions and few answers.

One area that I find fascinating is the use of brain games to improve memory, but we lack data in HIV ( You can read more here : http://www.sharpbrains.com/blog/2007/10/16/brain-teasers-and-games-for-adults-our-top-50/). It would be great if a researcher studied this non-traditional potential intervention for HIV related memory loss.

I personally would like to see studies that explore the use of higher doses of acetyl-l-carnitine, ADHD drugs, Nuvigil, exercise, and other interventions in improving neurocognitive function in HIV positives. Hopefully, we will see more intervention studies in this area and other areas related to aging with HIV sooner than later. At this point, I am getting very anxious as we see cohort data in conferences that only talk about incidence rates of this problem and others like decreased bone density, yet I see very little being done in looking into what we are actually going to do to reverse these effects of HIV or its treatments.

I hope this helps. You are not alone in this, and stay tuned!

Nelson More on the CHARTER study



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