Course Of Neurocognitive Complications

HIV-related neurocognitive complications differ from those seen in degenerative disorders, such as Alzheimer's disease or Parkinson's disease. Most persons with mild impairments do not progress to develop dementia; indeed, many recover and some have a relapsing-remitting course. This is illustrated by the data in Figs. 7 and 8, derived from research at the San Diego HIV Neurobehavioral Research Center (HNRC). In Fig. 7, it can be seen that after a period of 1 year only about half of the cases judged to have MCMD or asymptomatic neuropsychological impairment remain in the same category. About one-fifth improve, and a small proportion worsen. When data over a period of 5 years were considered, it was found that about one-fourth of HIV-infected persons had a "wobbly" or relapsing-remitting course. This pattern of waxing and waning symptomatology is consistent with the presumed underlying etiology, which is thought to be linked to periodic flare-ups of viral activity or immune activation within the central nervous system.

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