HIV-related dementia

Treatment of neurons with dualtropic X4R5 gpl20 has been shown to induce cytochrome c accumulation and caspase 9, 8, and 3 activation (Garden et al. 2002). Incidentally in the same studies, activated caspase 3 immunoreactivity was found in the brains of neuroAIDS patients. Furthermore, caspase 3 activation was found to be involved in the synaptic and dendritic injury (Garden et al. 2002). Chronic dendritic disrnption has been correlated with the severity of HIV-related dementia (as reviewed in Ellis et al. 2007). 

Early signs of HIV-related dementia dysphoric mood, apathy, social withdrawal... 

According to the CDC, the diagnosis of AIDS constitutes certain opportunistic infections, neoplasms, encephalopathy or wasting syndrome in the presence of HIV infection. In 1993, the CDC expanded the criteria to also include CD4+ T-cell count below 200 cells/p,l in the presence of HIV infection. The most common opportunistic infections includepneumocystis carinii pneumonia, pneumonitis, toxoplasmosis, mycobacterial disease, recurrent herpes simplex virus infection and/or cytomegalovirus infection. Kaposi s sarcoma is the most common form of cancer. HIV-related nervous system diseases include acute septic meningitis, AIDS dementia complex, subacute encephalitis, HIV encephalopathy and CNS opportunistic infections and neoplasm. 

HIV-1, HIV-2 Transmission via blood, sexual intercourse responsible for ARC, AIDS dementia, etc HIV-2 W African in origin closely related to HIV-1, but antigenically distinct... 

Considerable neuromuscular involvement also occurs in patients with AIDS.47 100 Peripheral neuropathies, myopathies, and various CNS manifestations (dementia, other psychological manifestations) can occur directly from HIV infection or secondarily, due to some other opportunistic infection.31 85 100 Likewise, peripheral neuropathies are a common side effect of certain anti-HIV drugs (didanosine, stavudine, zal-citabine), and myopathies are a side effect of zidovudine therapy.63 Patients with HIV disease often have painful symptoms such as joint pain, back pain, and pain related to neuropathies and myopathies.100 Hence, HIV disease can often be regarded as a degenerative neuromuscular disorder from the standpoint of a rehabilitation professional. Therapists can therefore help improve function and decrease pain in patients with HIV infection and AIDS.1 33... 

Note AIDS is caused by HIV, which impairs both cellular and humoral immune functions, and this results in increased susceptibility to opportunistic infection and certain malignancies. The medical aspects of HIV infection include AIDS-related complex (weight loss, chronic diarrhea, fever, thrush, herpes zoster, fatigue), opportunistic infections and cancer, end-stage renal disease, blindness (cytomegalovirus), HIV encephalopathy, and dementia. The psychological aspects of HIV infection include major depression, regression, and suicidal impulses, delirium, substance abuse, antisocial personality, and bereavement. 

Huang Y Erdmann N, Zhao J, Zheng J (2005a) The signaling and apoptotic effects of TNF-related apoptosis-inducing ligand in HIV-1 associated dementia. Neiuotox Res 8 135—148. 

Zheng J, Niemann D, Bauer M, Williams C, Lopez A, Erichsen D, Ryan LA, Cotter RL, Ghorpade A, Swindells S (2001) HIV-1 Glia Interactions in Interleukin-8 and Growth-Related Oncogene a Secretion, Neuronal Signaling and Demise Relevance for HIV-1-Associated Dementia. In 8th Conference on Retroviruses and... 

Stem Y, McDermott MP, Albert S, Palumbo D, Seines OA, McArthur J, Sacktor N, Schifitto G, Kieburtz K, Epstein L, Marder KS Dana Consortium on the Therapy of HIV-Dementia and Related Cognitive Disorders (2001) Factors associated with incident human immunodeficiency virus-dementia. Ai ch Neurol 58 473 79. 

In future work, we wiU extend and validate the different models to other class of diseases. Approximately 1-1.5 % of the French population suffer from dementia and the causes of dementia are neurological disorders such as Alzheimer s disease (which causes 50 %-70 % of aU dementia), blood flow-related (vascular) disorders such as multi-infarct diseases, inherited disorders such as Huntington s disease, and infections such as HIV [15]. In fact, we would like to simulate the patient s progress in order to forecast and to analyze the need for long, medium and short-term care. This allows us to evaluate human, financial and physical resources in the future. 

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