by John Otrompke
Dementia which occurs in people
with HIV can be distinguished from Alzheimer’s disease and warrants different
treatment, according to a poster presented at this year’s annual meeting of the
American Neurological Association, which took place virtually.
Markers for inflammation found in
HIV patients are associated with cognitive decline, whereas amyloid markers
were not, according to poster 368, “Peripheral Inflammation and Depressed Mood
Independently Predict Neurocognitive Worsening Over.”
“HIV dementia is different from
Alzheimer’s because it is one of the few treatable dementias. When patients go
on anti-retroviral therapy and achieve suppression, they also get cognitive
improvement,” explained Ronald Ellis, MD, PhD, professor at the University of
California-San Diego, lead author on the poster.
The researchers measured cognitive
decline over 12 years in 191 patients with HIV. Inflammation biomarkers such as
interleukin-6, C-reactive protein, and soluble tumor necrosis factor type II
were associated with greater neuro-cognitive decline (p=0.02), as was depressed
mood at entry (p=0.0004). On the other hand, biomarkers like amyloid beta 42
and solid amyloid precursor proteins (sometimes thought to be associated with
Alzheimer’s disease) were not associated with greater cognitive decline in HIV
patients.
There are other differences as
well, according to Ellis. “Although classic Alzheimer’s proceeds at a more
rapid rate, people with HIV develop cognitive problems earlier.”
And while viral suppression is
associated with cognitive improvement, it doesn’t restore cognition to normal,
he explained. However, researchers have speculated that treatment
intensification could actually reverse the decline, he added.
#ANA
#dementia
