The human immunodeficiency virus (HIV) infects the central nervous system (CNS), causing symptoms in most persons with AIDS-related complex (ARC) and AIDS, and in a significant proportion of those classified as asymptomatic seropositive. The most common clinical syndrome secondary to CNS infection is known as HIV encephalopathy. When sufficiently disabling, HIV encephalopathy is known as AIDS dementia, and must be reported to the Centers for Disease Control as a case of AIDS.

AIDS dementia is a complex of cognitive, affective, behavioral, and motor symptoms which varies widely in its presentation. In some persons, cognitive impairment predominates, manifesting in a loss of intellectual capacities such as short-term memory, information processing, and abstract thinking. When mood disturbance predominates, it may present as irritability, anxiety, depression, or mania. Behavioral complications are most often due to confusion or psychosis, and may render the patient difficult for caretakers to manage. Motor impairments include slowing, gait abnormalities, incontinence, and paralysis.

AIDS dementia presents a significant challenge to the public health system. Physicians, other health providers, and policymakers must be educated so that they may tackle the problems of diagnosis, acute and chronic care, and public safety which are related to this illness.



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