[New spectrum of HIV-associated cognitive disorders in the HAART era].
Highly active anti-retroviral therapy (HAART) has almost abolished HIV-related mortality and serious opportunistic diseases; among them, AIDS-related dementia. However, minor forms of cognitive dysfunction, have not disappeared, and even increased in frequency. Ageing of HIV+ patients, insufficient penetration of anti-viral drugs into the brain with continuous low-grade viral production and inflammation may play a role. Minor cognitive dysfunction in HIV infection shares some clinical and pathophysiological features with neuro-degenerative diseases, in particular Alzheimers disease. It can thus be postulated that, such in Alzheimer disease, anti-cholinesterase drugs might also be efficacious in AIDS-related minor cognitive dysfunction. This hypothesis has not been tested yet however A clinical trial using ravistigmine is starting this spring in patients with HIV-associated cognitive dysfunction in Geneva and Lausanne.
Du Pasquier
R
R
Service de Neurologie, CHUV, Lausanne.
Cavassini
M
M
Simioni
S
S
Annoni
J M
JM
Giacobini
E
E
Hirschel
B
B
D000465:Algorithms; D023241:Antiretroviral Therapy, Highly Active; D003072:Cognition Disorders / Q000209:etiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans