Question

Does HIV cause neurocognitive impairment on ART?

23 April 2023. Related: All topics, Living with HIV long-term, Support.

Hi there, does HIV cause neurocognitive impairment?

I’ve been reading some studies about HIV and I read something about that the chronic inflammation caused by HIV causes trouble to a person’s capacity of memory and learning. It is told that ARVs aren’t enough to avoid this effect of the disease.

Is this really true or is this something from the past?

The information from the studies seem way different from the so-called normal life that we see in health campaigns.

Many studies talk about problems, including ageing faster, having chronic diseases early in life, and these disturbing problems associated with neurocognitive capacity.

Answer

Answer: Simon Collins

Thanks – you ask great questions.

Like many other infections, HIV can cause neurocognitive complications, but this in now dramatically lower with effective treatment.

HIV treatment (called ART) is really effective and modern ARV’s mean you can lead a long and active life.

They keep your immune system strong by keeping your CD4 count from dropping. They also dramatically reduce the immune inflammation cause by having a high viral load.

Some studies report higher level of inflammation than if you were still HIV negative, but only by a little. However, this is only likely to cause clinical problems in a small percentage of people on ART. These people might also have other factors that increases the chance of other complications.

These factors can include having a very low CD4 count when you were diagnosed and before you started ART, but the risk is much less once you are on treatment. I can also include natural things like ageing and getting older.

This is why advice to have a healthy lifestyle is just as important if you are living with HIV.

So yes, HIV can still cause neurological problems on ART, but the risk is generally low.