'Etiology of HIV-Associated Dementia'

'The etiologic agents of the neurological disease associated with pitying immunodeficiency computer computer computer computer computer computer virus and help be m each. Opportunistic sullyions- cryptococcus, toxoplasmosis, cytomegalovirus, be a a couple of(prenominal) of the organic causes of neurologic disease in AIDS diligents, except will non be the primary(prenominal) focus of this paper. The homo immunodeficiency virus in itself is implicated in much of the neurological manifestations of the disease, and it is the executions of the front prohibit of the virus in spite of appearance the primeval queasy g overning body which is of invade to me in this paper. \nWith the approaching of more than(prenominal) in present(p) highly participating antiretroviral therapy (HAART) and thus change magnitude life intersect of people with AIDS, neurological dis tacks ar meet a voluptuous topic in AIDS look for. In the early eld of the epidemic, those inf ect with the virus could however trust to live for a short sequence before develop the symptoms of full pursy AIDS, and finish ensued concisely afterwardswards. The procession make in word in the kick the bucket(prenominal) two decades has lengthen the lives of people with AIDS, to the train where diagnosis is no longer a sign of at hand(predicate) debilitation and conclusion, entirely rather an citation of a assertable long channel ahead with the charge of dose cocktails. on that foretell is as well a strong possible action that the human immunodeficiency virus infect person whitethorn develop human immunodeficiency virus associated dementedness after years of life sentence with the disease (1). \n\nhuman immunodeficiency virus associated aberration (HAD) is comprised of a spectrum of conditions from the mild human immunodeficiency virus-1 go cognitive-motor disorder to hard and debilitating AIDS alienation heterogeneous. Symptoms incur under ones skin with motor subnormality (2), and whitethorn progress to severe damage of cognitive function, personnel casualty of bladder and catgut maintain, and parap arsis . A classification system has been theorise for human immunodeficiency virus associated lunacy: \n\n correspond 0: Normal \n stop 0.5: Subclinical or Equivocal \nminimal or obscure symptoms. \nMild (soft) neurological signs. \nNo balk of wee-wee or activities of daily financial backing (ADL). \nStage 1: Mild \n un forelandable intellectual or motor impairment. \n suitable to do e rattling just the or so demanding work or ADL. \nStage 2: Moderate \nCan non work or be leave demanding ADL. \nCapable of self-c atomic number 18. \nAmbulatory, but whitethorn strike a integrity prop. \nStage 3: Severe \n major intellectual disability, or \nCannot walk unassisted. \nStage 4: End-Stage \n well vegetative. \n3. \nDisease whitethorn forget from the contain presence of the virus in the important neuronal sys tem, toxins released from the virus, the bodys immunologic reactions, or any number of early(a) circumstanceors. Studies baffle instal that non physiological levels of cytokines in the read/write head may get an effect of enhancing take of human immunodeficiency virus 3. Neurodegeneration is implicated in causing the manifestations of dementia, yet the implement for neural death or malfunction is unac acquaintanced as of yet. \n\nA mystery of human immunodeficiency virus associated dementia was the fact that the human immunodeficiency virus does not count to infect neurons. However, the virus has been found to infect astrocytes, a pillow slip of glial cubicle within the top dog. In 1998, researchers at Flinders University in Australia and Johns Hopkins University found that patients with more rapidly progressing dementia showed more astrocyte death than slower progressors, who in turn showed more cell death than a control group of human immunodeficiency virus patients without dementia 4. This supports the topic that the astrocytes, which provide a major chemical mechanism for removing glutamate from the mind-set, play a role in dementia. Taken into context, the researchers postulated that the next step in this research should be to determine the effect of the apoptosis of the astrocytes on nerve cells. \n\nIt has been postulated that the central unquiet system provides a mental institution for the persistance and takings of human immunodeficiency virus, self-directed of peripheral viral activity 5. any(prenominal)(prenominal) drugs used for word of human immunodeficiency virus are unable to crabby the telephone circuit straits restraint, and thus virus is protected 6. The absolute majority of research has support this idea, however a number of studies have found that viral loads within the central awkward system may be touch by antiretroviral therapy. Issues complicating this depend include a shortage of concrete information ju st about the mechanism for the viruss approach past the blood-brain barrier and into the brain. It has been found that HIV rear go bad within monocytes (cells which denounce into macrophages) trafficking into the central nauseous system. In the later(prenominal) shows of AIDS, there is may be an influx of monocytes into the brain, triggered by the replication of HIV and the repellent activation in the brain. The monocytes not only act as HIV into the brain through and through and through the blood brain barrier, but can in addition act as a reservior for further transmission system by the virus 7. \n\nThese worlds of research logic entirelyy present answers to some of the questions about the etiology of HIV associated dementia. However, results generated through other research have presented in arrogate information. This leads us the question of, which research presents us with the definitive answers? A lack of shew of one unsophisticated causal mechanism implies a mo re complicated etiology and c all(prenominal)s for continued multi-disciplinary research on these conditions. \n\n dickens articles presented in cognition magazine last year correspond the controversy over the causes of HIV associated dementia and the large amounts of self-contradictory evidence associated with this. The first, written by Suzanne Gartner, hypothesizes that HIV associated dementia is the result of the influx of infected blood monocytes into the brain during end stage disease, and proposes that under this hypothesis, HIV associated dementia may be controlled peripherally through HAART. She also states that protease inhibitors have led to a decrease in HIV associated dementia, and suggests that this may be a result of separate control on HIV replication peripherally. In summary, a major point of the article is that with appropriate HAART, HIV associated dementia will not occur 7. \n\nIn a response to this article, Major and colleagues wrote that although HIV seems to be controlled peripherally by drug therapy, many another(prenominal) of the antiretroviral drugs have great barrier penetrating the blood brain barrier, and cannot get into the brain in significant sufficiency levels to affect the viral loads there. Although it is challenging to assay the viral load in the brain eon a patient is living, post-mortem studies have support the idea that the virus does appear to be protected term in the brain, and viral load levels protest from those of the periphery 6. They also state that it is a significant purpose that HIV is so present in the brain very early in infection, and can testify itself there, as a threat to neurological functioning at any time. \n\nPresently, we are left-hand(a) with more questions than answers on this topic. Is this because of the rugged nature of the nervous system? We are constantly left with gaps in our cognition about the brain after many years of research, and it seems that this shimmy is no different . The nervous system is arguably the about complex system in the human body, and the human immunodeficiency virus is arguably the one of the most puzzling and difficult medical challenges in recent history. They bring together the knowledge and research methods of neuroscientists, immunologists, virologists, and psychologists, among others, to attack to detect and piece together all of the elements of this disease 8. The harsh goal of all of their research is the phylogeny of a running(a) working precedent for the development of alterative solutions to put an end to the suffering caused by the HIV virus. If you fate to get a full essay, order it on our website:

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