In may be found in any age group although

In early
medicine, dementia was the collective term used for signs or symptoms showing acquired
deterioration or impairment of cognitive processes such as memory, thinking,
and reason in humans. The signs often start with delirium and then either
slowly proceed or advance greatly to loss of cognitive functions. They may be
found in any age group although it can be usually seen in adults or the elderly.
Also, this is more of a medically related disorder rather than psychiatric that
is, the causes stem from diseases or trauma that eventually or abruptly affect
cognitive processes in the human brain. Nowadays, the correct medical term is
Neurocognitive Disorder/s (NCD) and they can be classified into mild or major
NCD depending on the severity and then sub-classified into the cause of the
disorder of which there are nine medical conditions that affect cognitive
functions. The treatment for NCDs varies depending on its causative agent such
as HIV Infection. This paper will be discussing Neurocognitive disorder due to
HIV Infection and what is/are the current treatment/s being done for such a
condition.

 

 

Neurocognitive
Disorder due to HIV Infection and its treatment/s

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During earlier
years, HIV infection was a highly controversial topic. Nowadays, it has
eventually become another medical condition that needs effective treatment, prevention,
and preservation of the quality of life during and after treatment. The
infection has also become associated with NCD during the years of modern
therapy but patients have the option to either have treatment with combination
antiretroviral therapy (cART) or discontinue it.

The Human
Immunodeficiency Virus (HIV) can invade the central nervous system either via using
the brain for viral replication or during persistent infections thus affecting
cognitive functions (Deana et al, 2016). Modern treatments including
combination antiretroviral therapy (cART) or antiretroviral therapy (ART) focus
on viral replication and suppressing other secondary infections.

But
based on literature, some HIV infected patients were observed to have loss of
cognitive function during antiretroviral therapy (ART) (Heaton et al, 2010). With this information, one can pose a question
as to whether modern treatments can help or aggravate such conditions.

According
to Gannon et al (2011), “Although the severest form of HAND (HIV acquired neurocognitive disorder), HIV-associated dementia (HAD), is now rare due
to ART, the persistence of milder, functionally important HAND forms persist in
up to half of HIV-infected individuals. HAND prevalence may be higher in areas
of Africa where different HIV subtypes predominate, and ART regimens that are
more effective in suppressing CNS HIV replication can improve neurological
outcomes. HAND are correlated with persistent systemic and CNS inflammation,
and enhanced neuronal injury due to stimulant abuse (cocaine and
methamphetamine), aging, and possibly ART drugs themselves”. Thus, in the recent years,
the major forms of HAND may have been “controlled” but with neuropsychological testing,
milder forms still exist during therapy

Modern treatment still include cART even if milder
forms of HAND are observed to be present upon therapy since as stated above, these
drugs aim at keeping the virus in check or controlling other infections that cause
brain inflammation. Of course, lifestyle choice such as healthy living and refraining
from abuse of substance use may also contribute to effective therapy of patients.
There is also the choice of whether continuing treatment despite the possibility
that therapy drugs may or may not contribute to neurocognitive impairment. Despite
all these challenges, modern medicine still continues to study and explore possibilities
that can help alleviate HAND and possibly reverse effects of HIV infection on cognitive
function.

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