Los Angeles Times reports that the drug cocktails that have worked so well to prolong the lives of those who are infected with HIV may not do much to protect the brain:
A study published by the National Academy of Sciences last month used 3-D brain scans to see how much tissue was damaged. In vivid, color-coded images, researchers found up to 15% tissue loss in the centers that regulate movement and coordination, as well as a thinning of the language and reasoning centers.
“As people are living longer, the major risk of HIV is not the immune system anymore, but the brain,” said Dr. Paul Thompson, professor of neurology at the UCLA School of Medicine and author of the brain scan study. “People who are doing well with HIV, living with it for over 10 years, have this progressive damage going on in the brain, well before symptoms are obvious.”
[update – Matt Wynia explains that “Just to be clear on this. Highly active anti-retroviral therapy does a HUGE amoung to protect the brain. Patient with AIDS and previously incurable brain diseases are now often cured by starting HAART. Cerebral Toxoplasmosis, which used to be a common killer, is now rare, as is Cryptococcal meningitis. What is being seen now is that HIV continues to live in CNS tissue (which we have long known, since the drugs don’t penetrate the CNS all that well) and apparently, this has some local effects. That’s not good, but it is not the same as saying the drugs don’t do anything to protect the brain. They clearly protect the brain by preventing life-threatening CNS infections.”]