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HIV Robs Brain Power, Study Shows
Miami Herald (01.20.02) Stephen Smith
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AIDS 2002; 12:21-29. Jan 4
The Living Longer with HIV Study, begun four years ago in South Florida, is
finding that AIDS can rob patients of their mental faculties, a relentless
thievery unfolding across the years. The damage seems to be most severe among
older people. "It really is astounding to scientists how complex HIV proves
to be and how it can cause damage to multiple organ systems, including the
brain," said Dr. Karl Goodkin, a University of Miami (UM) psychiatrist who
has spent most of the past 20 years studying the virus. "As scientists, I
don't think it ever ceases to amaze us."
Goodkin and his colleagues are examining how HIV affects intellectual skills
and motor functioning of people 50 and older. More than a decade ago, Goodkin
and other researchers began to recognize the mental health ramifications of
the virus. HIV- associated dementia was manifested in patients during later
stages of AIDS, and less dramatic impairment was found even in infected
people without other symptoms of the disease. CDC data show that while
patients 50 and older made up 9.7 percent of AIDS cases in 1993, that
percentage rose to 13.4 percent in 1999. In South Florida, the burden borne
by people 50 and older is comparable - and even greater in some counties.
With a grant from the National Institutes of Health, in 1998 Goodkin began
recruiting 286 people toparticipate in his study. He seeks those who are
infected, as well as those who are not. So far, he has enrolled 196 who
undergo a battery of physical and psychological tests. The researchers found
that older HIV-positive participants have a level of symptoms approaching
twice that of younger infected people. The gap is almost as dramatic when
comparing infected older people with those who don't have the virus.
The researchers know that the brain can be the harbinger of a rebounding
infection in patients whose illness appears in check. HIV can sequester in
the brain. Many drugs used to treat AIDS do not penetrate brain tissue
effectively. Goodkin recommends that doctors begin performing a detailed
examination of the brain to detect concentrations of the AIDS virus.
The Living Longer with HIV Study is still seeking participants, including
people 50 and older who are HIV-positive or HIV-negative. Researchers can be
reached at: 305-243-6067.
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