A 68-year-old man who was a diagnosed case of HIV infection for last 12 years was brought to outpatient depament for evaluation. His wife repos that for last 6 months she has been noticing changes in his behaviour. She fuher added that ‘He appears uninterested and doesn’t seem to care about anything. I haven’t seen him crying or saying something negative, but may be he is getting depressed. He is also having difficulty remembering things ‘ The patient has been irregular with his HIV medications. His last CD4+ cell count, measured 5 months ago, was 210/mm3. While walking , patient was observed to have subtle jerking movements. Which of the following is the likely diagnosis?
Correct Answer: HIV-associated dementia
Description: It is a neurocognitive disorder, which is usually seen in untreated HIV patients with a CD4+ cell count of <200/mm3 and in patients with long-standing HIV disease. The onset is usually subacute and manifests with apathy and impairment of attention. Subcoical (e.g, basal ganglia, nigrostriatal) symptoms manifest early with symptoms such as slowed movement and difficulty with smooth limb movement. This is followed by coical symptoms such as memory decline. Regular antiretroviral therapy decreases the possibility of development of HIV associated dementia, and may be helpful even if the symptoms have already staed.
Category:
Psychiatry
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