City University of New York



Olena MasenkoProfessor HaqueBIO 2311-E118April 28th, 2020How HIV/AIDS affects the brainEverybody wants to stay healthy and well throughout their life. However, no matter what we do or how hard we try, we cannot always avoid getting sick at some point. Sometimes, the disease is not permanent or lifelong. We recover and resume our normal life but sometimes the illness can stay with us for the rest of our life. Some diseases can not only affect our bodies but can also affect our brain function leaving us unable to resume our regular way of life. One of the most debilitating diseases that can have terrible and permeant effects on the brain is the Human Immunodeficiency Virus or HIV. HIV is a virus that attacks the immune system, which is the body’s natural defense system against illnesses. If this is left untreated, and HIV progresses, the immune system will get weaker and weaker from being constantly attacked until it can no longer fight off life-threatening infections and diseases. Acquired Immune Deficiency Syndrome or AIDS is the result of the final stage of HIV infection, if it is left untreated (AVERT.)As HIV and AIDS battle your immune system, your central nervous system is also affected. HIV and AIDS both cause a number of neurological complications, particularly if HIV progresses to AIDS. Our body contains “T-helper lymphocyte cells which contain CD4 receptor sites. These cells help the immune system function normally and they fight off certain kinds of infections. They fight off these infections by acting as messengers to other types of immune system cells, giving them a message to become more active and fight against invading germs” (NCBI). “HIV has a code of genetic material, just like other viruses and this genetic material is made of ribonucleic acid or RNA. RNA is the information that the virus needs in order to replicate. The RNA in HIV has proteins called “reverse transcriptase” which is crucial for replication inside T-helper cells. They also contain proteins called antigens and they have diverse functions in viral replication. These antigens are like hooks on the outside of the virus, and they make it easier for the virus to hook onto the T-helper cells and infect them. HIV doesn't seem to take over the cells in your nervous system, but it does cause significant inflammation in the body. This inflammation can damage the spinal cord and brain and prevent your nerve cells from working the way that they should. Neurological complications may result not only from damage caused by the virus itself, but also from other side effects of HIV and AIDS, such as cancers that are associated with these diseases. Some of the drugs used to treat HIV and AIDS can also cause neurological complications while attempting to control the rapid spread of the virus.” (AIDS) Also, certain genetic factors can influence the risk of neurological side effects from HIV medicines. HIV can cause many different conditions that affect the nervous system:Dementia.?“When HIV becomes very advanced, HIV-associated dementia (HIV/AIDS encephalopathy) or AIDS dementia complex (ADC) can occur. These disorders impair cognitive function. This means that person may have trouble thinking, understanding, and remembering. Although the specific symptoms vary from person to person. This type of dementia can be deadly but it can often be prevented when antiretroviral medicines are taken correctly. AIDS dementia complex typically occurs as the CD4+ count falls to less than 200 cells/microliter. It may be the first sign of AIDS. With antiretroviral therapy (ART), the frequency of ADC has declined significantly. ART may not only prevent or delay the onset of AIDS dementia complex in people with HIV, it can also improve mental function in people who already have ADC” (WEB MD).HIV may affect the?brain?through several mechanisms. Viral proteins may damage nerve cells directly or can infect inflammatory cells in the?brain?and spinal cord. HIV may then induce these cells to damage and disable nerve cells. HIV causes generalized?inflammation, which?can cause?memory issues and heart disease.Viral infections.?HIV can increase your risk for several viral infections that affect the nervous system. Cytomegalovirus infections can negatively affect cognitive function, physical control (like the use of legs and arms and bladder control), vision and hearing, and your respiratory system, causing problems like pneumonia. People with AIDS are also likely to develop a herpes virus infection, like shingles, inflammation in the brain, and inflammation, in the spinal cord. Another condition, progressive multifocal leukoencephalopathy (PML) is also caused by the virus. PML is aggressive and dangerous. In some circumstances, it can be controlled with antiretroviral medicines. (JOHN HOPKINS).Fungal and parasitic infections.?Cryptococcal meningitis is caused by a fungus and can cause a severe inflammation of the spinal cord and brain. A parasite can cause an infection called toxoplasma encephalitis, which result in extremely painful headaches confusion and can even cause seizures. Some fungal infections can cause mild skin rashes, but others can lead like fungal meningitis which can result in death, Therefore, it’s important to treat these infections as soon as possible to try to avoid life-threatening complications (JOHN HOPKINS).Four of the most common fungal infections due to HIV are candidiasis, cryptococcosis, histoplasmosis, and coccidiomycosis (CDC).Candidiasis is caused by a type of yeast called?Candida. The?infection?is primarily found in the mouth and vagina. “Cryptococcosis is a potentially fatal fungal disease affecting more than one million people around the world each year. In people with HIV, it can often progress to a condition known as cryptococcal meningitis, which affects the central nervous system and is today the third most common complication in people with AIDS” (MEDICINE NET).“Histoplasmosis is caused by a common fungus called?H. capsulatum, which can be regularly found in solid?droppings, bird dropping, and bat guano. In people with advanced HIV, histoplasmosis can develop into a chronic lung infection similar to?tuberculosis.? It can spread beyond the lungs and affect multiple major organs in HIV-infected patients with?CD4 counts?under 150.” (MEDICINE NET)“ HYPERLINK "" Coccidioimycosis?is caused by the fungus?C. immitis?or?C. posadaii, and is commonly referred to as Valley Fever. Like cryptococcosis, coccidiomycosis is transmitted by fungal spores found in soil, which go airborne and are inhaled into the lungs.11? Symptoms are usually short-lasting and relatively mild.” (MEDICINE NET)However, when the infection spreads from the lungs to other organ systems it becomes an AIDS-defining condition, that results in serious illnesses such as ulcers, meningitis, bone lesions, and heart inflammation.Neuropathy.?HIV can cause damage to nerves throughout the body, resulting in significant pain or weakness, known as neuropathy. Neuropathy is most common in people with advanced HIV (JOHN HOPKINS).Vacuolar myelopathy.?“This condition occurs when tiny holes develop in the fibers of the nerves of the spinal cord. It causes difficulty walking, particularly as the condition gets worse. It's common in people with AIDS who aren't receiving treatment and also in children with HIV, Pathologically, it is characterized by vacuolization in the lateral and posterior columns of the thoracic spinal cord and has a striking similarity with the myelopathy of vitamin B12 deficiency. In autopsy series, 20% to 55% of patients with AIDS have evidence of spinal cord disease consistent with VM. The myelopathy usually manifests late in the course of the HIV infection, with slowly progressive weakness of the lower extremities, gait disorder, sensory abnormalities in the legs, impotence in men, and urinary frequency and urgency. Its course is invariably progressive and leads to severe paralysis of the lower limbs, with loss of the ability to walk and of sphincter control. There is no known treatment for AIDS myelopathy and there is no evidence that antiretroviral drugs can improve the symptoms or slow the progression of VM. The symptomatic treatment includes antispasticity agents, management of sphincter dysfunction, and physical therapy. Experimental treatments are being tested in clinical trials“ (JOHN HOPKINS)Psychological conditions. People with HIV or AIDS often develop anxiety disorders and suffer from depression. They may also experience hallucinations and significant changes in behavior. (JOHN HOPKINS)Lymphomas or AIDS related lymphomas are malignant tumors (cancers) that can develop in the lymph system of people diagnosed with HIV. People with HIV disease have an increased risk of developing these lymphomas and other types of?cancers. Lymphomas can be life-threatening, but good management of HIV can make treating lymphomas more successful. (JOHN HOPKINS)Neurosyphilis.? “If an HIV-infected person also has syphilis that goes untreated, it can quickly progress and damage the nervous system. It can cause the nerve cells to break down and lead to loss of vision and hearing, dementia, and difficulty walking. The presentations of Neurosyphilis vary but can include meningitis, meningovascular disease, general paresis and tabes dorsalis”?(JOHN HOPKINS). “Lumbar puncture was used to diagnose neurosyphils, but because this procedure is unpopular with patients and involves risks, the investigators recommend that all HIV-positive patients diagnosed with early syphilis should receive antibiotic therapy that has good penetration into the central nervous system (CNS). Incidence of the sexually transmitted infection syphilis is high among patients with HIV, most especially among men who have sex with men (MSM), and incidence has risen since 2000. Neurosyphilis is of especial concern for individuals with HIV as it could exacerbate the cognitive decline that has been associated with HIV infection in some research” (NAM AIDS MAP)Once HIV begins affecting your immune system, it can cause many different symptoms. HIV-related neurological complications may lead to: suddenly forgetting things all the time or acting confused; It can result in feeling weak that keeps getting worse, losing feeling in your legs or arms and problems with balance and coordination It can cause headaches, changes in vision; difficulty swallowing and seizures. It can also lead to mental health problems like anxiety and depression. (JOHN HOPKINS)“With HIV’s capability of reversing the natural process that takes place in cells, by transforming RNA into DNA it is considered to be a retrovirus. HIV belongs to a subgroup of retroviruses known as “slow” viruses, where it takes the virus up to 12 years or more from the initial infection for the virus to begin to show serious symptoms.” (AVERT)Antiretroviral medicines are used to stop HIV from replicating and spreading throughout the body. They are also used to help reduce the risk that it will cause damage to the nervous system. (URMC)Specific neurological conditions and complications are treated differently. Cancer may be treated with chemotherapy and radiation, and bacterial infections need antibiotics. Certain medicines may help manage viral infections, and medicines to manage pain can help to ease nerve pain. Counseling and medicines, including antidepressants, may be used to manage some of the psychological conditions associated with HIV. (URMC)Nobody wants to get sick, especially with such terrible effects on our bodies and our mind. We have to be very careful and try to avoid getting diseases, but sometimes it is inevitable. Having HIV or AIDs can cause many subsequent illnesses and infections that can result in severe damage to the brain and the body. These illnesses and infections are neuropathies, cancers, dementia, etc. Sometimes, with proper care and medicine, the effect of this disease can be slowed down and its side effects lessened. However, with so many problems that can result due to this disease such as weakness, paralysis, seizures, memory loss, and possible death, it is more prudent to avoid contracting it since there is so much information available now on how to avoid getting HIV/AIDS. Works Cited“AIDS INFO” How HIV Causes AIDS. October 1st 2001. Accessed April 20st, 2020“AVERT” The science of HIV and AIDS – Overview. . October 10th, 2019. Accessed April 15th 2020.“CDC” People living with HIV/AIDS. . January 25th, 2017. Accessed April 21st, 2020. “JOHN HOPKINS MEDICINE” Neurological Complications of HIV. . Accessed April 14th, 2020“MEDICINE NET” Diseases and Conditions. . Accessed April 14th, 2020.“NAM AIDSMAP” Sexually transmitted infections epidemiology. . October 10th 2015. Accessed April 15th, 2020“NCBI” The defense mechanisms of the adaptive immune system. August 4th, 2016. Accessed April 15th 2020.“URMC” Neurological Complications of HIV. . Accessed April 14th, 2020. “WEB MD” HIV and AIDS Dementia. . Accessed April 14th, 2020. ................
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