Dementia in HIV-Positive Individuals Can Negatively Affect Treatment Regimen

Approximately one-fifth of all HIV-positive individuals experience dementia, which can pose problems for HIV-positive patients and their doctors, Long Island Newsday reports. According to doctors, HIV-related memory problems, which occur earlier than dementia associated with old age, are "just beginning to come into focus" as HIV-positive patients on highly active antiretroviral treatment are living longer. Memory loss and the impaired ability to execute complex tasks can cause serious problems for HIV-positive patients, who often have to remember to take a complex regimen of medications. The effectiveness of HAART is compromised if fewer than 90% of the prescribed pills are taken each day. Further complicating the problem is the fact that many patients and doctors want to "den[y]" the existence of dementia, Dr. Marshall Forstein, medical director of mental health and addiction services at Fenway Community Health, said, adding that the symptoms of dementia are often mistaken for signs of depression or HIV-related stress. Dr. Justin McArthur, professor of neurology and epidemiology at Johns Hopkins University School of Medicine, has had success with electronic beepers that remind a patient to take medication, and a similar study is now being carried out using cell phones programmed to ring at certain times to remind patients to take their pills. McArthur is also studying the effect of the Parkinson's disease drug selegiline on the brains of HIV-positive patients (Talan, Long Island Newsday, 10/15).