Rapidly progressive dementia as the initial presentation of human immunodeficiency virus infection
DOI:
https://doi.org/10.23938/ASSN.1002Keywords:
Human immunodeficiency virus, HIV, HIV dementiaAbstract
Dementia associated with human immunodeficiency virus (HIV) is currently a rare cause of rapidly progressive dementia. Its appearance is not only limited to the late phases of the disease, but can sometimes be the presenting symptom.
We present the case of a patient who debuted with anxious-depressive symptoms and rapid cognitive deterioration with early repercussions on his daily functionality. HIV was detected in the study, with a higher viral load in cerebrospinal fluid than in plasma. Despite a torpid course at the beginning, antiretroviral therapy brought about a progressive improvement in the cognitive sphere, consistent with the decrease in the viral load.
Although rare, HIV continues to be a cause of dementia that primary care and hospital care professionals should not forget. The relevance of its early diagnosis lies in its potentially reversible nature.
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References
GESCHWIND MD. Rapidly progressive dementia. Continuum (Minneap Minn) 2016; 22: 510-537. https://doi.org/10.1212/CON.0000000000000319
KOPSTEIN M, MOHLMAN DJ. HIV-1 encephalopathy and aids dementia complex. Treasure Island (FL): StatPearls, 2021. https://www.ncbi.nlm.nih.gov/books/NBK507700/#_NBK507700_pubdet_
OSTERRIETH PA. [La prueba de copiar una figura compleja: contribución al estudio de la percepción y la memoria]. Arch Psychol 1944; 30: 286-356.
SCHOUTEN J, CINQUE P, GISSLEN M, REISS P, PORTEGIES P. HIV-1 infection and cognitive impairment in the CART era: a review. AIDS 2011; 25: 561-75. https://doi.org/10.1097/QAD.0b013e3283437f9a
BAI F, IANNUZZI F, MERLINI E, BORGHI L, TINCATI C, TRUNFIO M et al. Clinical and viro-immunological correlates of HIV associated neurocognitive disorders (HAND) in a cohort of antiretroviral-naïve HIV-infected patients. AIDS 2017; 31: 311-314. https://doi.org/10.1097/QAD.0000000000001346
BECKER JT, KINGSLEY LA, MOLSBERRY S, REYNOLDS S, ARONOW A, LEVINE AJ et al. Cohort profile: recruitment cohorts in the neuropsychological substudy of the multicenter AIDS cohort study. Int J Epidemiol 2015; 44: 1506-1516. https://doi.org/10.1093/ije/dyu092
Panel de expertos del Grupo de Estudio de SIDA (GeSIDA). Documento de consenso sobre el manejo clínico de la comorbilidad neuropsiquiátrica y cognitiva asociada a la infección por VIH-1. https://gesida-seimc.org/wp-content/uploads/2021/02/Guia_GESIDA_ManejoClinicoComorbilidad.pdf
RAFFETTI E, POSTORINO MC, CASTELLI F, CASARI S, CASTERNUOVO F, MAGGIOLO F et al. The risk of late or advanced presentation of HIV infected patients is still high, associated factors evolve but impact on overall mortality is vanishing over calendar years: results from the Italian MASTER cohort. BMC Public Health 2016; 16: 878. https://doi.org/10.1186/s12889-016-3477-z
CLIFFORD DB. HIV-associated neurocognitive disorders: epidemiology, clínical manifestations, and diagnosis. En: Ghandi RT, Bogorodskaya M, editores. UpToDate: Waltham (MA), 2020. https://www.uptodate.com/contents/hiv-associated-neurocognitive-disorders-epidemiology-clinical-manifestations-and-diagnosis
DIAZ MM, ZACARÍAS MG, SOTOLONGO P, SANES MF, FRANKLIN DJ, MARQUINE MJ et al. Characterization of HIV-associated neurocognitive impairment in middle-aged and older persons with HIV in Lima, Peru. Front Neurol 2021; 12: 629257. https://doi.org/10.3389/fneur.2021.629257
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