AIDS dementia complex

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Background

  • Also referred to as HIV encephalopathy
  • Progressive disorder heralded by impairment of recent memory and other cognitive deficits
  • Occurs in 10-15% of HIV+ patients; 30% of patients with CD4 <100
  • Diagnosis of exclusion

Clinical Features

Differential Diagnosis

Altered mental status

Diffuse brain dysfunction

Primary CNS disease or trauma

Psychiatric

HIV associated conditions

Evaluation

  • Evaluate for alternate/reversible causes of symptoms
  • Head CT shows cortical atrophy and ventricular enlargement
  • Associated with elevated CSF protein in 50-70% of cases

Management

  • HAART
  • Supportive care

Disposition

See Also

References

  1. Gutteridge, David L MD, MPH, Egan, Daniel J. MD. The HIV-Infected Adult Patient in The Emergency Department: The Changing Landscape of the Disease. Emergency Medicine Practice: An Evidence-Based Approach to Emergency Medicine. Vol 18, Num 2. Feb 2016.