So you think you know what AIDS is?
My mom’s best friend, Gail, succumbed to AIDS. So did Angel, one of the main characters in the Broadway musical RENT.
I played Mimi’s mom one summer in the musical RENT, so understandably, I didn’t exactly relate to Angel’s experience. Or Gail’s experience, for that matter.
Years after that awkward summer before high school, I’m learning about AIDS in my neuroscience class. So I’d like to reexamine this faintly familiar disease, AIDS, from a more recent and informed perspective.
AIDS (A-acquired I-immune D-deficiency S-syndrome) is caused by an HIV (H-human I-immunodeficiency V-virus) infection.
Autopsies of AIDS patients show that most (75%) had brain damage . Such brain damage can lead to mild neurocognitive disorder or even a special form of HIV-associated dementia. Damage is localized in the hippocampus, cerebral cortex, and basal ganglia, characterized by neuron death and synapse damage. (The hippocampus is most known for its role in storing memories, while the basal ganglia is involved in movement disorders like Parkinson’s Disease, and the cerebral cortex…well…is implicated in higher functions like thought and action…so like, all of human behavior…)
Unfortunately, viruses may be active in the brain even if blood tests turn out negative. This means patients must be monitored for changes in cognitive abilities and affective state. Such changes may include forgetfulness, slow thinking and reasoning, and difficulties finding the right words. Muteness is also possible. Motor problems start with tremors and patients may have trouble making complex movements, then may become bedridden.
The odd thing about HIV is that the virus doesn’t infect neurons, even though the infection certainly causes brain damage. HIV lives and clones itself in astrocytes, which are a type of support cell for the brain.
But once the HIV infection is discovered, combination antiretroviral therapy (cART) can help reduce or prevent brain damage. In fact, compared to around 25 years ago, the infection is much more easily chronically managed, which is wonderful .
Thankfully, treatments are continuing to improve for neurodegenerative disorders. (for Parkinson’s Disease too — see my other blog entry on Parkinson’s here: https://medium.com/@lnovitz/sunday-morning-football-and-parkinsons-disease-72fbc2075ca1#.5jdiuvpek).
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 Levy, R. M., & Bredesen, D. E. (1989). Controversies in HIV-related central nervous system disease: Neuropsychological aspects of HIV-1 infection. AIDS Clinical Review, 151–191.
 Carlson, N. R. (2013). Physiology of behavior.
 Broder, S. (2010). The development of antiretroviral therapy and its impact on the HIV-1/AIDS pandemic. Antiviral Research, 85(1), 1. http://doi.org/10.1016/j.antiviral.2009.10.002