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How possible to get Parkinson and Schizophrenia with AIDS

Aug 31, 2011

Hello Dr Frascino,

Lately, I am reading a lot this site and the answers from all the experts in effort to understand my nephews condition and help him. Hope you have the chance to read my long story and answer my many questions. It will help us a lot.

Two months, my nephew who is 23 years old and lives in Greece was diagnosed with AIDS after admitting to the hospital with infectious pneumonia. He thinks he got infected with HIV in 2007 but we dont recall any health issues that time. He had protected sex twice with a female sex-worker at that time. Nothing went wrong with the condom but he still got HIV. Is this possible (assuming the woman was already infected)?

In 2009 he joined the army for his one year military service. During this period he lost lots of weight, but we didnt worry since he was overweight since his childhood and thought losing weight is a good thing for him. He also seemed to miss home, so we thought this might contribute to lose weight. After he finished his military service and got back home his weight stabilized pretty much. I should also mention that the last 3-4 years he was having various skin problems.

Since April 2011 he started to lose weight again, had more skin problems, getting irritated easily but he still was doing his routine and attending his school. In June 2011 lost more weight and had short breath so he went to the hospital where he was diagnosed with the infectious pneumonia and AIDS. I dont know his blood counts, but the doctor said that his immune system has collapsed and the prognosis was a few months. By that time he got more symptoms: tremor in hands when he was trying to eat (actually he had a hard time to eat because of his tremor), his movements got quite slower, his upper body structure changed dramatically with his shoulders bending inward and up, his chest bones became asymmetrical (right side is higher than the left), he got rashes on his faces and white things in his mouth. His behavior changed too, he started to talk less. The psychologist said that he had delusions for example when he was at army and school he avoided food because he was afraid that it might be poising. But I must say, when he was at home he seemed to be very OK with the people and the food.

At the hospital he was treated for the pneumonia and the neurological condition, he was released after ten days and he was put on prezolon and Olanzapinecen, rispefar. After 10 days staying at home the pneumonia reoccurred and he was admitted again to the hospital, this time to an AIDS clinics. He was treated for pneumonia, AIDS, mental and neurological conditions. He has been released from the hospital about 16 days now. Currently he is on Kaletra, Combivir, zithromax, fungustatin, risperdal, zyprexa, akineton retard.

Now he is at home and he doesnt seem to recover that well. One day he gets a fever, the other day he gets nausea and vomits especially after his breakfast (milk with cereal), has no the appetite, he feels constantly tiredness and sleepiness. His tremor got a little better, but still his movements are slow. He still has the rash. After starting all these meds his mood changed completely, he stays all day in bed and he doesnt talk or communicate easily, he seems that he just exists and not lives.

Are all these medicines reasonable for the symptoms he had when he admitted to the hospital? Is it possible to get Parkinson and schizophrenia from AIDS and so suddenly just at the time an opportunistic disease occurred and with no signs before that? Can someone get Parkinson so young? I kinda question the doctors diagnosis for parkinson and schizophrenia.... Don't they need to monitor the patient for sometime to have such a diagnosis?

I am reading that AIDS is a chronic disease, but it seems that my nephew is getting many serious symptoms and diseases. Any chance for him to recover? Is there anything else that can be done to improve his symptoms eg nutrition supplements , physiotherapy, anything..? Any special diet? Why his upper body shape changed so rapidly?

Thank you very much for your time. Marthda

Response from Dr. Frascino

Hello, Marthda.

I'm sorry to hear your nephew is having such a difficult time. Unfortunately without being able to completely review his medical history, medical records and all laboratory tests and to perform a physical examination, it's not possible for me to provide direct answers to your questions. I'll make a few general comments, but suggest you talk to his HIV specialist for more detailed and specific information about your nephew's clinical course and prognosis. If you do not trust his current physician's assessment or advice, you could suggest your nephew get a second opinion from another HIV specialist physician in your area.

Regarding his "protected sex" with the sex worker, HIV cannot permeate intact latex. However, condoms are not always used correctly; consequently, it's possible that despite using a condom the encounter was not fully protected.

HIV/AIDS has become more manageable, but there is still no cure and not everyone responds the same way to treatment. It would seem, in retrospect, that your nephew has had HIV for quite some time, because he now carries a full AIDS diagnosis and apparently has an opportunistic infection.

HIV/AIDS can affect the brain in many ways. An HIV-knowledgable psychiatrist and neurologist would need to assess his cognitive and neurological function and impairment.

As for any hope of recovery, his best hope is to work closely with an HIV physician specialist. If he responds to an effective combination of antiretrovirals his HIV viral load should decrease and hopefully allow for some degree of immune reconstitution (rise in CD4 count and CD4%). He will also need to be treated aggressively for any currently active opportunistic infections (OIs) and given prophylaxis against other OIs. Marthda, there is always hope. I have seen cases of amazing improvement once the correct diagnoses are made and appropriate treatment begun.

Continue to peruse the wealth of knowledge on this site, in its archives and on the related links. Hopefully it will lead to a better understanding of HIV. However, the best source of specific information about your nephew would be his HIV physician specialist.

Please give your nephew a hug from me.

Dr. Bob

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