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HIV Robs Brain Power, Study Shows
Miami Herald (01.20.02) Stephen Smith
  AIDS 2002; 12:21-29. Jan 4
The Living Longer with HIV Study, begun four years ago in South Florida, is finding that AIDS can rob patients of their mental faculties, a relentless thievery unfolding across the years. The damage seems to be most severe among older people. "It really is astounding to scientists how complex HIV proves to be and how it can cause damage to multiple organ systems, including the brain," said Dr. Karl Goodkin, a University of Miami (UM) psychiatrist who has spent most of the past 20 years studying the virus. "As scientists, I don't think it ever ceases to amaze us."
Goodkin and his colleagues are examining how HIV affects intellectual skills and motor functioning of people 50 and older. More than a decade ago, Goodkin and other researchers began to recognize the mental health ramifications of the virus. HIV- associated dementia was manifested in patients during later stages of AIDS, and less dramatic impairment was found even in infected people without other symptoms of the disease. CDC data show that while patients 50 and older made up 9.7 percent of AIDS cases in 1993, that percentage rose to 13.4 percent in 1999. In South Florida, the burden borne by people 50 and older is comparable - and even greater in some counties.
With a grant from the National Institutes of Health, in 1998 Goodkin began recruiting 286 people toparticipate in his study. He seeks those who are infected, as well as those who are not. So far, he has enrolled 196 who undergo a battery of physical and psychological tests. The researchers found that older HIV-positive participants have a level of symptoms approaching twice that of younger infected people. The gap is almost as dramatic when comparing infected older people with those who don't have the virus.
The researchers know that the brain can be the harbinger of a rebounding infection in patients whose illness appears in check. HIV can sequester in the brain. Many drugs used to treat AIDS do not penetrate brain tissue effectively. Goodkin recommends that doctors begin performing a detailed examination of the brain to detect concentrations of the AIDS virus.
The Living Longer with HIV Study is still seeking participants, including people 50 and older who are HIV-positive or HIV-negative. Researchers can be reached at: 305-243-6067.
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