II. Epidemiology

  1. Common complication in late AIDS

III. Pathophysiology

  1. Spectrum from subtle deficits to HIV-Associated Dementia
  2. Higher severity (including Dementia) with decreasing CD4 Counts
  3. Involves three neurologic domains
    1. Cognitive (memory, concentration, planning, comprehension)
    2. Behavioral (apathy, depression, Agitation)
    3. Motor (Incoordination, unsteady gait, Tremor)

IV. Signs

  1. Early
    1. Impaired concentration
    2. Forgetfulness
    3. Slowed cognitive function
  2. Late
    1. Impaired rapid movements
    2. Hyperreflexia
    3. Release reflexes
    4. Weakness
    5. Ataxia
    6. Spasticity
    7. Bladder and bowel Incontinence
    8. Myoclonus

VI. Imaging: Brain MRI findings

  1. Cerebral atrophy
  2. Patchy, diffuse increased white matter signal intensity
    1. Excludes other causes

VII. Labs: CSF Exam

  1. Mildly elevated Protein
  2. Mild Pleocytosis, predominance of mononuclear cells

IX. Management

  1. Antiretroviral drugs
    1. May improve neuropsychiatric performance
    2. May alleviate symptoms

X. Complications

  1. Poor compliance with Antiretroviral therapy (with risk of resistance)
  2. Decreased functional capacity

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Related Studies

Ontology: AIDS Dementia Complex (C0001849)

Definition (CSP) neurological complications characterized by abnormalities in cognition, motor performance, and behavior due to HIV infection.
Definition (MSH) A neurologic condition associated with the ACQUIRED IMMUNODEFICIENCY SYNDROME and characterized by impaired concentration and memory, slowness of hand movements, ATAXIA, incontinence, apathy, and gait difficulties associated with HIV-1 viral infection of the central nervous system. Pathologic examination of the brain reveals white matter rarefaction, perivascular infiltrates of lymphocytes, foamy macrophages, and multinucleated giant cells. (From Adams et al., Principles of Neurology, 6th ed, pp760-1; N Engl J Med, 1995 Apr 6;332(14):934-40)
Concepts Disease or Syndrome (T047)
MSH D015526
ICD10 F02.4
SnomedCT 421529006, 12741002, 192178000
DSM4 294.9
English AIDS Dementia Complex, Complex, AIDS Dementia, Dementia, HIV, HIV Dementia, Dementia Due to HIV Disease, ADC - AIDS dementia complex, HIV-Associated Cognitive Motor Complex, Dementia in human immunodeficiency virus [HIV] disease, ADC - Acquired immune deficiency syndrome dementia complex, Acquired immune deficiency syndrome dementia complex, AIDS - Acquired immune deficiency syndrome dementia complex, Acquired immune deficiency syndrome-related dementia, Dementia associated with AIDS, DEMENTIA COMPLEX AIDS RELAT, HIV ASSOC COGNITIVE MOTOR COMPLEX, DEMENTIA COMPLEX ACQUIRED IMMUNE DEFIC SYNDROME, ACQUIRED IMMUNE DEFIC SYNDROME DEMENTIA COMPLEX, AIDS RELAT DEMENTIA COMPLEX, AIDS - AIDS dementia complex, acquired immunodeficiency syndrome (AIDS) dementia, acquired immunodeficiency syndrome (AIDS) dementia (diagnosis), Acquired-Immune Deficiency Syndrome Dementia Complex, Dementia Complex, Acquired Immune Deficiency Syndrome, Dementia Complex, AIDS, AIDS Related Dementia Complex, AIDS-Related Dementia Complex, Complex, AIDS-Related Dementia, Dementia Complex, AIDS Related, Dementia Complex, AIDS-Related, Dementias, HIV, HIV Dementias, AIDS Dementia Complex [Disease/Finding], dementia HIV, aids-related dementia, dementia AIDS, HIV dementia, HIV Associated Cognitive Motor Complex, HIV associated cognitive and motor complex, HIV associated cognitive motor complex, AIDS with dementia (disorder), Acquired immune deficiency syndrome dementia complex (disorder), AIDS with dementia, Dementia associated with AIDS (disorder), Dementia associated with acquired immunodeficiency syndrome, Dementia associated with acquired immunodeficiency syndrome (disorder), HIV disease; dementia (etiology), HIV disease; dementia (manifestation), HIV disease; resulting in, dementia (etiology), HIV disease; resulting in, dementia (manifestation), dementia; human immunodeficiency virus disease (etiology), dementia; human immunodeficiency virus disease (manifestation), AIDS with dementia, NOS, AIDS Dementia, AIDS dementia complex, AIDS-related dementia, AIDS-dementia complex, AIDS dementia, Dementia due to HIV disease, HIV-related dementia, aids dementia complex, Aids dementia complex
Dutch AIDS dementiecomplex, AIDS-gerelateerde dementie, HIV gerelateerde dementie, AIDS-dementiecomplex, dementie door HIV ziekte, AIDS-dementie, HIV-ziekte; dementie, HIV-ziekte; leidend tot, dementie, dementie; Humaan Immunodeficiëntievirus-ziekte, Dementie bij AIDS [ziekte door Humaan Immunodeficiëntievirus, HIV], ADC, Aidsdementiecomplex (ADC), Complex, aidsdementie- (ADC), Dementiecomplex, aidsgerelateerd, HIV-dementie, HIV-geassocieerd cognitief-motorisch complexi
French Complexe de démence associé au SIDA, Démence complexe du sida, Démence liée au sida, Démence due à la maladie VIH, Démence du sida, Syndrome démentiel lié au SIDA, Démence liée au VIH, Démence associée au SIDA
German AIDS-Demenz-Komplex, von AIDS verursachte Demenz, HIV-bedingte Demenz, AIDS-bedingte Demenz, Demenz infolge HIV-Syndrom, Demenz bei HIV-Krankheit [Humane Immundefizienz-Viruskrankheit], AIDS-Demenz-Syndrom, HIV-Demenz, AIDS-Related Demenz-Syndrom, HIV-Associated Cognitive Motor Complex
Italian AIDS dementia complex, Complesso AIDS-demenza, Demenza da infezione di virus dell'immunodeficienza umana, Demenza da AIDS, Demenza AIDS-correlata, Demenza correlata a virus dell'immunodeficienza umana, Complesso cognitivo-motorio associato ad HIV, Dementia complex correlata a sindrome da immunodeficienza acquisita, Demenza da HIV, Dementia complex correlata ad AIDS
Portuguese Complexo de demência da SIDA, Complexo demência-SIDA, Demência relacionada com SIDA, Demência de SIDA, Demência relacionada com HIV, Demência por doença HIV, Complexo Motor Cognitivo Associado ao HIV, Complexo Motor Cognitivo Associado ao HIV-1, Complexo AIDS Demência, Complexo Demencial da AIDS, Complexo Motor Cognitivo HIV-Associado, Demência por HIV
Spanish Complejo de demencia del SIDA, demencia asociada con SIDA (trastorno), complejo demencia-SIDA, demencia asociada con SIDA, Complejo demencia-SIDA, Demencia relacionada con el VIH, Demencia relacionada con el SIDA, Demencia por SIDA, Demencia por enfermedad por VIH, SIDA con demencia (trastorno), SIDA con demencia, Complejo Demencial del SIDA, Complejo Motor Cognitivo Asociado a VIH, Complejo SIDA Demencia, Demencia por VIH
Japanese エイズ関連認知症, HIV疾患による認知症, HIV関連認知症, エイズニンチショウ, HIVシッカンニヨルニンチショウ, HIVカンレンニンチショウ, エイズカンレンニンチショウ, エイズニンチショウフクゴウ, HIV痴呆, 痴呆-HIV, 脳症-HIV, HIV認知症, 認知症-HIV, エイズ認知症, 痴呆-AIDS, HIV付随認知的運動群, HIV-1付随認知的運動群, 脳症-AIDS, HIV脳症, 認知症-AIDS, AIDS脳症, エイズ痴呆, エイズ脳症, AIDS認知症複合, AIDS認知症, エイズ認知症複合症, AIDS痴呆, AIDS認知症複合症, エイズ認知症複合
Swedish AIDS-demens
Czech AIDS - komplex demence, AIDS demence, Demence související s HIV, Demence způsobená HIV infekcí, Komplex AIDS-demence, Komplex demence spojený s AIDS, demence u infekce HIV
Finnish AIDS-dementia
Russian SPID, ENTSEFOLOPATIIA, VICH, DEMENTSIIA, VICH, ENTSEFALOPATIIA, SPID, SLABOUMIIA KOMPLEKS, ВИЧ, ДЕМЕНЦИЯ, ВИЧ, ЭНЦЕФАЛОПАТИЯ, СПИД, СЛАБОУМИЯ КОМПЛЕКС, СПИД, ЭНЦЕФОЛОПАТИЯ
Korean 인체면역결핍바이러스병에서의 치매
Polish Zespół otępienny AIDS, Otępienie w przebiegu AIDS, Demencja w przebiegu AIDS, Encefalopatia w zakażeniu HIV, Encefalopatia w AIDS, Zespół AIDS-otępienie, Otępienie związane z neuroinfekcją HIV
Hungarian AIDS-dementia komplex, AIDS dementia, AIDS-szel összefüggő dementia, HIV betegség okozta dementia, HIV dementia
Norwegian Demens ved aids-infeksjon, Aids-demenssyndrom, Demens ved hiv-sykdom