Question
Will HIV gradually effect my brain?
9 May 2024. Related: All topics, CD4 and viral load, Complications and coinfections, Living with HIV long-term, Opportunistic infections.
Do people living with HIV get intercranial infections?
Diagnosed 2018, RITA test showed recent infection on ARV’s and undetectable fairly quickly and have remained so. Will HIV gradually effect my brain?
Answer
Hi, how are you doing?
It is great to hear that you became undetectable so soon after starting treatment. Do you know what your current CD4 count is?
Research into HIV and the brain is very complicated and this is an area which can be controversial as experts can disagree.
Being on ART is likely to reduce the risk for most people of ever having brain-related complications. However a small minority of people might have higher risks of problems and this might be related to their lowest ever CD4 count or how long it took before starting effective ART. But is also might depend on other aspects of your health and factors that you cant really control such as genetics and family history.
Other good news includes that HIV doesn’t seem to increase the risk of other common complications such as Alzheimer’s or Parkinson’s disease.
The risk to your brain depends on your CD4 count and any damage that HIV has done. As you are undetectable HIV is no longer impacting your health and your immune system is not being damaged by HIV.
When you have a stable CD4 count and an undetectable viral load while on treatment, HIV does not gradually effect your brain. There is some limited evidence that HIV can cause a steady level of background inflammation in the central nervous system but the impact on not greatly understood.
While viral load can be suppressed, treatment does not penetrate the brain and spine very well. HIV can remain dormant in these areas, meaning it is not active, but the presence of the virus can cause some level of inflammation. The impact of this is reduced by being able to start treatment as soon as possible from infection.
The impact of this background inflammation is unknown but there is some risk of brain changes. Prior to ART the risk of HIV associated dementia was more than 25% and now with treatment this is less than 5%.
Other brain related changes include infections (viral, fungal and parasitic), cancers and neuropathies. All being dependant on CD4 count and when in a healthy range, the additional risk to the general population becomes negligible.
Josh.
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