In the mid to late 1980s, up to half of all people with HIV eventually developed debilitating dementia or a serious brain-related infection. Fortunately, this is no longer true, at least not in countries where potent antiretroviral (ARV) therapy is widely available.
Today, HIV-associated dementia (known as HAD or AIDS dementia complex, ADC) is rarely diagnosed. However, recent evidence suggests that HIV is still affecting people’s brains—even when HIV levels are undetectable in the blood.
This is certainly no reason to panic. So far, it appears that HIV-associated neurocognitive disorder (HAND) is so mild that people don’t notice it. Often, it can only be picked up with extensive neurological and psychological testing. What’s more, some evidence suggests that people who take ARVs that pass into the brain might be less prone to develop neurocognitive problems.
There is still much we need to understand about how HIV affects the brain in people with well-controlled disease: How common it is, which people are most vulnerable to HIV-related brain damage, and whether and how quickly it can progress from a mild disorder to one that is more serious. Researchers are hard at work to answer these questions and to determine whether there are medications that can slow or minimize HIV-related neurocognitive problems.
In the meantime, there are things that you can do—such as minimizing heavy alcohol and substance use, treating depression and anxiety, and getting physical exercise—to help keep the brain healthy and functioning well. This lesson will help you understand HAND and the latest thinking on how common it is and how it might be prevented or treated.