First confirmed case of Alzheimer's disease in HIV-positive patients to be submitted to CWC 2016 -
The first case of Alzheimer's disease diagnosed in an HIV-positive individual will presented in a poster session at the international Conference of the Alzheimer Association in 2016 in Toronto July 27. concluding a man of 71, triggering awareness on HIV survivors now reached the age where Alzheimer risk begins to degenerate.
the case was first published online April 15 in the open access journal of Alzheimer's disease and dementia: diagnosis, assessment and monitoring of diseases . Georgetown neurologist R. Scott Turner, MD, PhD, the patient was diagnosed after a PET scan showed amyloid deposition in the brain. Up to this point, Turner said, clinicians thought that people living with HIV may not develop AD because HIV-related inflammation in the brain can prevent amyloid clumps from forming.
"This patient may be a case of sentinel challenging what we thought we knew about dementia in people with HIV," said Turner, who heads the Memory Disorders Program at Georgetown University Medical Center .
further, Turner said the result suggests that some elderly dementia HIV patients may be misdiagnosed with neurocognitive disorders associated with HIV (MAIN) when they can develop AD. It may also be possible that some patients experience HAND and AD - a new type of mixed dementia, says Turner "Infection and amyloid chronic deposition of HIV with aging can be a" double hit "to the brain which causes progressive dementia."
. "Although it can be difficult to diagnose the cause of dementia in HIV-positive patients, diagnostic questions, because the hand and AD are treated differently," he said. "in Alzheimer's disease, we now four drugs approved by the FDA and more effective treatments are on the way. For HAND, we prescribe anti-retroviral drugs that have a better chance of getting into the brain. So to get a correct diagnosis is important and a crucial first step to advance the field. "
HAND develops in 30-50 percent of people with a long-term HIV infection. but the symptoms of the hand are identical to those of AD, Turner said He adds:.. "the medical community assumes dementia with HIV is caused by hand doctors are not considered as Alzheimer's disease, so it is possible that a number of older HIV-positive people may be misdiagnosed. "
The studies published to point to only five people with hands who underwent PET imaging amyloid, and all were negative day; However, the oldest of these patients was 67, Turner said.
The diagnosis of dementia in older people with HIV is on the rise. adults HIV infected over 55 are the age group the fastest growing HIV-positive population.
According to the latest CDC HIV Surveillance Report with data through 2013, 53,000 people in the US living with HIV are 65 and older, the age when the risk of disease Alzheimer's begins to degenerate. This number is expected to double in less than 10 years and does not include those who have not been diagnosed. Worldwide, over 37 million people living with HIV.
"This case reveals important new information on the specific question of neurological disorders related to HIV," said Jeffrey Crowley, MPH, director of the national program on HIV / AIDS Initiative at the O'Neill Institute national law and global health at Georgetown law. Crowley is former director of the Office of the White House National AIDS policy and senior advisor on disability policy. "This finding should lead to studies based on the additional population, as well as clinical and programmatic interventions in a timely manner to better support people living with HIV who are facing neurological decline. "
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