HIV can affect the brain, as it is a place where HIV hides out. As a result, people living with HIV may experience variable impacts to movement, memory and concentration, known as HIV-Associated Neurocognitive Disorder (HAND). HAND can be mild (and sometimes go unnoticed) or it can be severe and debilitating (and so significantly affect daily life). Signs and symptoms of HAND can occur even if a person is taking HIV medication (combination antiretroviral therapy) and no matter how long you’ve been living with HIV.
HAND can be subtle and not fully noticeable but still affect how you function daily. Signs and symptoms may include slower movement, muscle coordination and balance affects – such as bumping into or dropping things unintentionally, or tripping, stumbling or falling. They may involve mental slowing and thinking, such as reduced ability to recall a name or word, or to remember something or concentrate. Speech can also be affected. You might also experience changes in mood such as sudden anxiety or greater frustration and irritation with things that did not bother you before. Cognitive (thinking) impairment might also occur, such as forgetting things (dates, events, and appointments), loosing track of a conversation or time, or increased difficulty organising and preparing for your daily activities and duties.
Friends, partners and family may notice before you do. Early diagnosis and treatment are the keys to a better outcome. If you are unsure if HAND is affecting you, it’s a good idea to raise any concerns with your HIV doctor, as HAND is distinct from similar signs and symptoms from merely growing older or the occasional forgetfulness most people experience. Growing older is a normal process of general body slowing, whereas HAND can progress beyond this and lead to more serious brain effects such as dementia and other neurological (nervous system) concerns normally under the control of the brain.
Assessment of HAND is usually through a neurocognitive (question and answer type) screening test. If needed, further testing can done with a MRI (brain scan). Diagnosis also involves excluding other causes, such as other disease states or infections, or excessive tobacco smoking, recreational drugs and alcohol (which can affect brain and neurological functioning). Diagnosis of HAND can be relief if you been dealing with uncertainty of symptoms, and with clinical help seek ways to lessen or reverse the concerns. This may involve a change in your HIV antiretroviral treatments or some other medications as well. Mental tools and strategies, such as reminder services and brain training techniques may also assist; along with a nutritious diet, aerobic exercise and healthy lifestyle pursuits.
More Info? The below resources may help you be aware of any changes in your mental state and body so that you can seek effective therapy and support early, to help you develop strategies and access appropriate therapy to overcome HAND and maintain a good quality life.
Need more help? Speak to your doctor or contact QPP for assistance and support.