HIV can cross the brain-blood barrier (move from your blood into your brain), infecting cells in your nervous system. Most immune cells can’t cross that barrier, which surrounds the brain and spinal cord, so HIV can escape where the immune system can not follow. It enters the brain shortly after initial infection – typically within the first several times – but does not cause considerable damage straight away.
HIV in the brain does not go after your neurons, those significant brain cells responsible for transmission of electric impulses that control the body. Instead, it goes after other cells which have long lives. Once within these long-lived cells, HIV can remain in a latent condition for an elongated time period. As opposed to directly killing brain cells – as it does with CD4 T-cells elsewhere on your body – HIV affects your mind by setting off a cascade of damages through inflammation and oxidative stress caused by free radicals.
Why is this important for you? The harm that HIV causes to your mind and to your central nervous system may impair your neurocognitive functions. That could bring on symptoms like poor attention, memory lapses, and mood changes. Understanding what your viral load is on your cerebrospinal fluid (CSF) and your blood plasma is something to look at this when working with your physician in your treatment regimen. Some antiretroviral drugs are better than others in crossing the blood-brain barrier and they can affect your CSF viral load.
Reducing your viral load in the plasma and CSF may be required to decrease neurocognitive impairment, but it won’t halt all the inflammatory reactions or completely reverse the damage brought on by HIV’s march on the brain.This is not too different than some the changes that occur when you age – it just speeds up them. While effective antiretroviral therapy and recovery of your immune system dramatically reduce the incidence of these complications on mind and acute HIV-related dementia, mild-to-moderate impairment of your neurocognitive and engine functions remains a concern even with therapy.
In plain English, this means your brain won’t function as well as it should and you may begin forgetting things or having difficulty with fine motor skills like playing the guitar. How does this influence your own path? There appears to be a never ending flow of data which you must know to stay informed about HIV.
Choosing to be a complete partner in your therapy and understanding everything you can about how HIV affects your body will be a massive decision for you. Battles must be waged on several fronts to manage HIV in your body. HIV isn’t only a disorder of your immune system – it impacts many of your important organs. It will need to be your decision to remain on top of what is going on inside your body and what’s happening with your therapy. While it might seem that HIV has removed some of your options, it’s presented you with an entire set of new ones. The power is yours. What path will you choose?