New approach to dementia

Doctors are concerned that as many as 20 per cent of people with HIV may be experiencing problems remembering, carrying out complex tasks, organising paperwork - or following a strict anti-HIV drug taking schedule.
There are concerns too that HIV patients - surviving longer due to effective treatments - will go on to experience dementia at ages far younger than usual.
HIV infects monocytes, blood cells that can move

through the barrier between the bloodstream and the brain. They trigger inflammation in the brain cells that can change the way they work.
Anti-HIV drugs can partially suppress HIV in the brain, but regimes can also come with side effects - including problems in thinking clearly. These problems can have a direct effect on taking your drugs.
But simple measures can help to overcome them. Dr J C McArthur of John Hopkins University, USA, gave half of a cohort of patients a beeper that prompted them to take their medicine twice a day.
“Those who were reminded took three times the number of pills as those who did not have the beeper,” McArthur said. “We are now repeating the study using mobile phones.”
When patients are examined post-mortem, some patients with HIV have damage to the basal ganglia - the same part of the brain affected in Parkinson’s disease. But while Parkinson’s destroys the cells, in Aids dementia the problem is massive inflammation - the cells are trying to combat infection with HIV, but are failing to work properly as a result.

McArthur and colleagues have been testing selegiline, a Parkinson’s drug that blocks the inflammation process, in the treatment of Aids-related dementia.