1. OI: Dementia -- ÆGIS A comprehensive guide to this condition called ADC, dementia, sub acute encephalitis or HIV encephalitis Category Health Conditions and Diseases aids dementia complex......aids dementia complex (ADC) is not a true opportunistic infection. It is one ofthe few conditions caused directly by the HIV virus. aids dementia complex. http://www.aegis.com/topics/oi/oi-adc.html

AIDS Dementia Complex "ADC" "dementia" "sub acute encephalitis" "HIV encephalitis" This is part of a series on Opportunistic Infections . Please note that This Page Is Just A Starting Point: who specializes in treating HIV. Finding The Latest Information: Advances in treating opportunistic infections can happen at any time, so the material on this page may be outdated. Some links in the see also section at the bottom of this page are actually special database links. They may contain information published after this page was written. Classification AIDS Dementia Comples (ADS) is not a true opportunistic infection. It is one of the few conditions caused directly by the HIV virus. Description The central nervous system can be damaged by a number of things opportunistic infections; direct effects of HIV in the brain; toxic effects of drug treatments. Those with ADC have HIV-infected macrophages in the brain. That means HIV is actively infecting brain cells. Symptoms: Early symptoms of AIDS Dementia can be confused with general manifestations of clinical depression. These include apathy, loss of interest in one's surroundings and the like. Later symptoms involve cognitive and motor problems. Memory loss, as well as mobility problems, come into the picture. ( Being Alive The US Centers For Disease Control considers HIV encephalopathy (dementia) an AIDS-defining condition Danger Zone A.D.C. can happen at

2. SF AIDS Fdn: BETA 12/96 -- AIDS Dementia Complex This article is from the Dec. 96 Bulletin of Experimental Treatments for AIDS. In depth and covers the symptoms, classifications, diagnosis, treatment and prevention. http://www.sfaf.org/treatment/beta/b31/b31adc.html

Published in the Bulletin of Experimental Treatments for AIDS December 1996 issue, by the San Francisco AIDS Foundation. December 1996 Table of Contents Main Page beta@sfaf.org AIDS Dementia Complex by Mark Bowers HIV is known to affect most if not all systems in the body. A member of the subfamily of retroviruses that causes a variety of neurological and immunological diseases, HIV has been found in the brain as early as 2 days after initial infection. A type of dementia usually referred to as AIDS dementia complex (ADC), but also known as HIV-1-associated dementia or HIV-associated cognitive/motor complex, has been estimated to affect up to one-third of adults and one-half of all children with AIDS. It remains unclear exactly how and where HIV enters the brain. However, newly devised methods of measuring HIV in the cerebrospinal fluid (CSF) that bathes the spinal cord and the brain may be predictive of the risk of developing ADC and may help gauge efforts to prevent or treat it. The availability of antiretroviral drugs from 2 new classes, protease inhibitors and non-nucleoside reverse transcriptase inhibitors (NNRTI), potentially increases the number of options for preventing and treating ADC. New and better understanding of how HIV causes disease in the brain opens the door for testing novel therapies, including anti-inflammatory drugs, antioxidants, cytokine regulators and calcium channel blockers.

3. AIDS Dementia Complex aids dementia complex up. Related topics http://omni.ac.uk/browse/mesh/detail/C0001849L0001849.html

AIDS Dementia Complex [up] Related topics: broader Dementia HIV Infections other AIDS-Related Opportunistic Infections Acquired Immunodeficiency Syndrome Acquired Immunodeficiency Syndrome Alzheimer Disease ... Brain briefings : HIV's brain assault This is one of the Brain Briefing newsletters produced by the Society for Neuroscience specifically for a lay audience. The aim of these patient-oriented documents is "to explain how basic neuroscience discoveries lead to clinical applications". This document titled "HIV's Brain Assault" covers HIV-associated dementia, HIV and acquired immunodeficiency syndrome (AIDS), HIV's relationship with the brain and current therapy being tested with patients. Written in December 1999, this document contains illustrations and images. AIDS Dementia Complex Acquired Immunodeficiency Syndrome Brain HIV ... Patient Education Last modified 28/Mar/2003 [Low Graphics]

4. AIDS Dementia Complex-The Neurologic AIDS Research Consortium, Washington Univer aids dementia complex. aids dementia complex (ADC) is characterized by cognitive dysfunction (trouble with concentration, http://www.neuro.wustl.edu/narc/adc.html

Neurologic AIDS Research Consortium AIDS Dementia Complex Recently completed experimental studies include the following: Open studies include the following: A5090 opened in the fall of 2001. It is a trial using transdermal selegiline for treatment of HIV related motor cognitive disorder. This study is jointly sponsored by NARC and the ACTG system, and will test the safety and efficacy of selegiline (deprenyl) patches for this disorder. It follows up an earlier small study that suggested efficacy for this agent in the setting of AIDS dementia. The study will be placebo controlled for the first 24 weeks, then open label for an additional 24 weeks. The Protocol Chair is Dr. Giovanni Schifitto, University of Rochester. Approximately twelve NARC sites are conducting this study. As of October 2002, thirty-seven subjects had been enrolled, with a target sample size of 120. To contact a site near you, please refer to the list of centers with NeuroAIDS expertise. ACTG 736 is an observational longitudinal study to evaluate the relationships among HIV virus in the blood and the CSF, immune status, and the development of cognitive impairment in subjects receiving potent antiretroviral therapy. The protocol is available to individuals beginning a potent antiretroviral regimen or switching regimens due to virologic failure. In order to enroll, subjects must have a CD4 count less than 200 cells and plasma HIV-1 RNA level greater than 2,000 copies OR any CD4 count with plasma level greater than 50,000 copies. Dr. Christina Marra, University of Washington, is the protocol chair. The target accrual is 100.

5. AIDS Dementia Complex - HIV: Health And Medical Information About HIV And AIDS A brief article about aids dementia complex. http://www.medterms.com/script/main/art.asp?articlekey=8700

6. AIDS Dementia Complex aids dementia complex Back to previous level Supranuclear Palsy, Progressive Search PUBMED for Supranuclear Palsy, Progressive All Review Therapy Diagnosis Progressive Supranuclear Palsy NIH http://www.ohsu.edu/cliniweb/C10/C10.228.228.57.html

AIDS Dementia Complex Back to previous level Supranuclear Palsy, Progressive Search PUBMED for Supranuclear Palsy, Progressive: All Review Therapy Diagnosis ... Progressive supranuclear palsy (Steele-Richardson-Olszewski syndome): Med. Coll. of Wisconsin

7. (BALA) AIDS Dementia Complex The incidence of aids dementia complex is something less than 10%. Nonetheless,a majority (BALA) aids dementia complex BEING ALIVE February http://www.aegis.com/pubs/bala/1995/ba950206.html

BALA) AIDS Dementia Complex BEING ALIVE: February 1995 Mark Katz, MD, and reported by Jim Stoecker The incidence of AIDS Dementia Complex is something less than 10%. Nonetheless, a majority of people with late stage AIDS will manifest some symptoms. AIDS Dementia Complex was first described in 1986 and was added to the CDC's list of AIDS-defining conditions. Only a small number receive an AIDS diagnosis because of dementia . In 1990, for instance, just 2.7% of AIDS cases were defined because of AIDS Dementia. Early symptoms of AIDS Dementia can be confused with general manifestations of clinical depression. These include apathy, loss of interest in one's surroundings and the like. Later symptoms involve cognitive and motor problems. Memory loss, as well as mobility problems, come into the picture. Diagnosing AIDS Dementia Complex is difficult. CAT scans are usually used, though these could be normal. Neuropsychiatric testing is required. Various other scans may also be called for. Treatment is usually individualized; there is no one accepted way to treat all cases. AZT in high doses is usually used, although the drug appears to help more with motor problems and less with cognitive problems. Other drugs to reduce brain inflammation may also be tried. Finally, there is symptomatic treatment; drugs are used to treat the specific symptoms of the individual.

8. AIDS Dementia Complex The three components of the term, aids dementia complex embody central features of the condition. AIDS emphasizes its http://hivinsite.ucsf.edu/InSite.jsp?page=kb-04&doc=kb-04-01-03

9. AIDS Dementia Complex Introduction The aids dementia complex (ADC) is one of the most commonand clinically important CNS complications of late HIV1 infection. http://hivinsite.ucsf.edu/InSite.jsp?doc=kb-04-01-03

10. EMedicine - HIV-1 Encephalopathy And AIDS Dementia Complex : Article By Florian HIV1 Encephalopathy and aids dementia complex - aids dementia complex(ADC) is one of several conditions that may be caused by HIV itself. http://www.emedicine.com/NEURO/topic447.htm

document.write(''); (advertisement) Home Specialties CME PDA ... Patient Education Articles Images CME Patient Education Advanced Search Link to this site Back to: eMedicine Specialties Neurology Neurological Infections HIV-1 Encephalopathy and AIDS Dementia Complex Last Updated: January 18, 2002 Rate this Article Email to a Colleague Synonyms and related keywords: AIDS dementia complex, ADC, HIV-1–associated cognitive/motor complex, AIDS encephalopathy, HIV encephalopathy, subacute HIV encephalitis, HIV-associated dementia complex, AIDS-related dementia, HIV dementia, acquired immunodeficiency syndrome, AIDS AUTHOR INFORMATION Section 1 of 10 Author Information Introduction Clinical Differentials ... Bibliography Author: Florian P Thomas, MD, PhD, Drmed , Associate Program Director, Associate Professor, Departments of Neurology, Molecular Virology, Molecular Microbiology, and Immunology, Saint Louis University School of Medicine Florian P Thomas, MD, PhD, Drmed, is a member of the following medical societies: American Academy of Neurology, and National Multiple Sclerosis Society Editor(s): Michael J Schneck, MD

11. EMedicine - Dementia Due To HIV Disease : Article Excerpt By: Soma Sahai, MD In 1986, this disorder was termed aids dementia complex (ADC) to describea unique constellation of neurobehavioral findings. ADC http://www.emedicine.com/med/byname/dementia-due-to-hiv-disease.htm

(advertisement) Excerpt from Dementia Due to HIV Disease Synonyms, Key Words, and Related Terms: Please click here to view the full topic text: Dementia Due to HIV Disease Background: Physicians frequently encounter neurologic and psychiatric complications in patients with human immunodeficiency virus (HIV) infection. HIV dementia is a common source of morbidity, usually observed in late stages of HIV disease. In 1986, this disorder was termed AIDS dementia complex (ADC) to describe a unique constellation of neurobehavioral findings. ADC now is considered a single entity with a broad and varied spectrum of clinical presentations and severity. Pathophysiology: Pathological changes predominantly are subcortical, involving the deep gray (ie, basal ganglia, thalamus) and white matter regions; it is a syndrome that specialists term subcortical dementia. The primary mechanism of neuronal dysfunction is the infiltration of infected macrophages or microglial cells into the brain, which then elaborate proinflammatory diffusable cellular neurotoxins, including tumor necrosis factor-alpha (TNF-alpha), cytokines, and interleukins. HIV does not directly infect the neuron itself, but the neuron is damaged by the effect of various proinflammatory neurotoxins. Using immunohistochemical techniques, researchers identified the HIV gp41 antigen abundantly in the brains of patients with HIV dementia. The results of these studies still are unclear about whether the HIV gp41 antigen is the only pathogenic mechanism. Other viral products are implicated in HIV dementia. A surface protein of HIV, gp120 causes neuronal death in vitro and is accompanied by the opening of calcium channels in the neuronal membrane. The basal ganglia show the highest immunostaining by the HIV p-24 antigen. Some studies show that gp41 expression in the basal ganglia and frontal lobes correlates significantly with the severity of dementia.

12. Project Inform's AIDS Dementia Complex (ADC) [ HIV / AIDS Treatment Information] aids dementia complex (ADC)—dementia caused by HIV infection—is a complicatedsyndrome made up of different nervous system and mental symptoms. http://www.projinf.org/fs/dementia.html

Search Contact Us Feedback Calendar ... Site Map AIDS Dementia Complex April 2002 View PDF Esta información en español (Spanish Translation) TABLE OF CONTENTS Possible Symptoms of Early Stage ADC Possible Symptoms of Middle Stage ADC Possible Symptoms of Late Stage ADC What Is ADC? ... Conclusion The frequency of ADC increases with advancing HIV disease and as CD4+ cell counts decrease. It is fairly uncommon in people with early HIV disease, but it's more common in people with severely weakened immune systems and symptoms of advanced disease. Severe ADC is almost exclusively seen only in people with advanced HIV disease. ADC consists of many conditions that can be of varying degrees and may progressively worsen. These conditions can easily be mistaken for symptoms of other common HIV-associated problems including depression, drug side effects or opportunistic infections that affect the brain like toxoplasmosis or lymphoma. Symptoms of ADC may include poor concentration, forgetfulness, loss of short- or long-term memory, social withdrawal, slowed thinking, short attention span, irritability, apathy (lack of caring or concern for oneself or others), weakness, poor coordination, impaired judgment, problems with vision and personality change. Because ADC varies so much from person to person, it is poorly understood and has been reported and described in many conflicting ways. This publication will shed light on some of these issues as well as the available treatments for ADC.

13. Janfeb Quinolinic Acid May Have Role in aids dementia complex. Reuters Health Information Services (12/22/97) http://www.straighthiv.homestead.com/janfeb.html

Dementia.doc StraightHiv.com Dementia 2 Dementia 3. Click here to go back to straighthiv.com Homepage

14. The Neurologic AIDS Research Consortium, Washington University, St. Louis, MO Studies currently available include treatment trials for aids dementia complex,peripheral neuropathy, and progressive multifocal leukoencephalopathy. http://www.neuro.wustl.edu/narc/

Neurologic AIDS Research Consortium RETURN TO LIST OF NEURO. DEPT PROGRAMS The Neurologic AIDS Research Consortium (NARC) is supported by the National Institutes of Health to design and carry out clinical trials to improve the therapy for HIV induced neurologic disease, and neurologic conditions associated with the AIDS virus. This consortium was established in 1993 when the NARC grant submitted by David B. Clifford, M.D . of Washington University School of Medicine was funded by the National Institute of Neurologic Disorders and Stroke (NINDS) to establish the consortium. Since that time the grant has supported studies of the natural history of neurologic performance in advanced AIDS, treatment of HIV associated peripheral neuropathy, progressive multifocal leukoencephalopathy, and cytomegalovirus. The NARC primarily sponsors studies in conjunction with the AIDS Clinical Trials Group (ACTG) . Studies currently available include treatment trials for AIDS dementia complex, peripheral neuropathy, and progressive multifocal

15. The Body: Project Inform -- AIDS Dementia Complex aids dementia complex, from Project Inform, at The Body, the complete AIDS/HIVinformation resource. The Body The HIV/AIDS Authority. aids dementia complex. http://www.thebody.com/pinf/dementia.html

Information, Inspiration, and Advocacy for People Living with HIV/AIDS PDF AIDS Dementia Complex April 2002 Table of Contents Possible Symptoms of Early Stage ADC Possible Symptoms of Middle Stage ADC Possible Symptoms of Late Stage ADC What Is ADC? ... Conclusion Dementia is a brain disorder that affects a person's ability to think clearly and can impact his or her daily activities. AIDS dementia complex (ADC) dementia caused by HIV infection is a complicated syndrome made up of different nervous system and mental symptoms. These symptoms are somewhat common in people with HIV disease. The frequency of ADC increases with advancing HIV disease and as CD4+ cell counts decrease. It is fairly uncommon in people with early HIV disease, but it's more common in people with severely weakened immune systems and symptoms of advanced disease. Severe ADC is almost exclusively seen only in people with advanced HIV disease. ADC consists of many conditions that can be of varying degrees and may progressively worsen. These conditions can easily be mistaken for symptoms of other common HIV-associated problems including depression, drug side effects or opportunistic infections that affect the brain like toxoplasmosis or lymphoma. Symptoms of ADC may include poor concentration, forgetfulness, loss of short- or long-term memory, social withdrawal, slowed thinking, short attention span, irritability, apathy (lack of caring or concern for oneself or others), weakness, poor coordination, impaired judgment, problems with vision and personality change.

16. Slide-show: 19: AIDS Dementia Complex 19. aids dementia complex. HMPAOSPECT perfusion images transaxial, sagittal andcoronal slices in red and green scales. Transaxial. Sagittal. Coronal. Transaxial. http://brighamrad.harvard.edu/education/online/BrainSPECT/Main_Slide_Show/Main_S

AIDS Dementia Complex HMPAO-SPECT perfusion images: transaxial, sagittal and coronal slices in red and green scales Transaxial Sagittal Coronal Transaxial Sagittal Coronal Globally decreased perfusion with high background. Multiple small perfusion defects in the inferior parietal and lateral temporal cortex, bilaterally. Asymmetric uptake in the basal ganglia and thalami. NEXT: Chronic fatigue syndrome (case 2: pre and post treatment) B. Leonard Holman Puneet K. Chandak Basem M. Garada Last updated: Aug 23, 1995

17. AIDS Dementia Complex aids dementia complex Dementia in HIV. Book, Home Page. http://www.fpnotebook.com/HIV47.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement HIV Neurology Assorted Pages Neurologic manifestations of HIV AIDS Dementia Complex Focal Brain Lesion in HIV HIV related Myelopathy ... HIV related Neuropathy AIDS Dementia Complex Dementia in HIV Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter HIV Index Cardiovascular Medicine Dental Dermatology Endocrinology Otolaryngology Examination Ophthalmology Gastroenterology Gynecology Hematology and Oncology Infectious Disease Laboratory General Pulmonology Neurology Obstetrics Pediatrics Pharmacology Prevention Nephrology Rheumatology Page Neurology Index Approach Dementia Lesion Brain Myelopathy Neuropathy Epidemiology Common complication in late AIDS Pathophysiology Cognitive, behavioral, and motor dysfunction

18. AIDS SA - AIDS Dementia Complex characteristics of the dementia associated with HIV infection was first describedby Navia in 1986 who coined the term aids dementia complex (ADC) . http://www.niv.ac.za/virussa/aidsa/v7_3.htm

Pathogenesis Diagnosis Clinical Features Management The neuropathological characteristics of the dementia associated with HIV infection was first described by Navia in 1986 who coined the term "AIDS dementia complex (ADC)" . The disease has also been referred to by the WHO as well as the American Academy of Neurology by the rather cumbersome and seldom used alternate term, "HIV-associated cognitive/motor complex" Initially, ADC was seen in 15 to 30% of HIV infected patients, virtually always in the advanced stage of AIDS, and usually accompanied by a profound immunosuppression as well as other signs of AIDS. In developed countries, the incidence of ADC has dropped dramatically because of the widespread use of zidovudine and it is now a rare disease in those patients who are on zidovudine treatment. ADC is a diffuse CNS disorder, charac-terized clinically as a subcortical dementia which manifests itself by slowness of mental function and by disturbances of cognitive and motor functions. The disease, if untreated, is progressive with patients ultimately reaching a vegetative state before death. The mortality rate for ADC is 3 times that of Pneumocystis pneumonia. Replication of HIV in the CNS plays a key role in the pathogenesis and therefore the disease is treatable by antiretroviral agents, especially zidovudine, which penetrates readily into the CNS, and much of the neurological damage is reversible. PATHOGENESIS The pathogenesis of ADC is marked by the following features:-

19. Neurological Disorders: AIDS Dementia Complex Opportunistic Infections. aids dementia complex. Effects of zidovudine in 30 patientswith mild to endstage aids dementia complex. AIDS 7 683-92, 1993. http://www.hivpositive.com/f-Oi/OppInfections/4-Neuro/4-Neu-Demen.html

AIDS Dementia Complex The most important CNS complication, that has been attributed to a primary effect of HIV, has been described using a variety of terms, including the AIDS dementia complex (ADC), subacute encephalitis and HIV encephalitis. The syndrome may represent more than one type of disease process. It is characterized by decreased concentration and rapidity of thought, loss of interest in activities, and slowness of motor movements. The link between HIV infection in the brain or in the body and this neurological condition still remains uncertain. While it is clear that patients severely affected by this disorder have HIV-infected macrophages within the brain, those with milder disease have not been shown to have active virus infection within the brain. Return to the Neurological Disorders Menu REFERENCES: Tozzi V et al. Effects of zidovudine in 30 patients with mild to end-stage AIDS dementia complex. AIDS 7: 683-92, 1993. Wolters P et al. The effects of dideoxyinosine (ddI) on the cognitive functioning of children with HIV infection after 6 and 10 months of treatment. VII Intl Conf AIDS, Florence. Vol 2: 194(W.B. 2051), 1991. Yachoan R et al. Long term toxicity/activity profile of 2Õ,3Õ-dideoxyinosine in AIDS or AIDS-related complex. Lancet 336: 526-29, 1990.

20. Neurological Disorders Menu REFERENCES Tozzi V et al. Effects of zidovudine in 30 patients with mild toendstage aids dementia complex. AIDS 7 683-92, 1993. Wolters P et al. http://www.hivpositive.com/f-Oi/OppInfections/4-Neuro/4-NeuroSubMenu.html

Neurological Disorders Central nervous system (CNS) and peripheral nervous system (PNS) disorders in HIV-infected individuals may result from opportunistic infections, neoplasms and processes that appear to be primary effects of human immunodeficieny virus (HIV) itself. The nervous system may also be damaged as a result of the toxic effects of various treatments. Indeed, the majority of AIDS patients will eventually manifest one or more of these neurological conditions. Primary Effects of HIV on the CNS AIDS Dementia Complex Treatment Results Other CNS Conditions Complicating ... Return to the Neurological Disorders Menu REFERENCES: Tozzi V et al. Effects of zidovudine in 30 patients with mild to end-stage AIDS dementia complex. AIDS 7: 683-92, 1993. Wolters P et al. The effects of dideoxyinosine (ddI) on the cognitive functioning of children with HIV infection after 6 and 10 months of treatment. VII Intl Conf AIDS, Florence. Vol 2: 194(W.B. 2051), 1991. Yachoan R et al. Long term toxicity/activity profile of 2Õ,3Õ-dideoxyinosine in AIDS or AIDS-related complex. Lancet 336: 526-29, 1990. OTHER REPORTS: Aronow H et al. The management of the neurological complications of HIV infection and AIDS. AIDS 2(suppl 1): S 151-9, 1988.

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