Chapter: Diseases of The Brain and Nervous System(A Health Education Guide): Infectious diseases of the brain

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AIDS and the Nervous system

AIDS means Acquired Immuno-Deficiency Syndrome that occurs due to HIV i.e. Human Immuno-Deficiency virus. It affects the immune system of the body, causing many problems. AIDS is not just a single disease, it points towards a group of diseases.

AIDS and the Nervous system

AIDS means Acquired Immuno-Deficiency Syndrome that occurs due to HIV i.e. Human Immuno-Deficiency virus. It affects the immune system of the body, causing many problems. AIDS is not just a single disease, it points towards a group of diseases.

Normally, our body has two types of mechanisms to fight against infections.

Cell mediated immunity -provided by the Lymphocytes

 

Humoral immunity - conferred by the antibodies.

HIV hampers the functioning of the T-lymphocytes by infecting them as well as decreasing their numbers. Due to the dwindling of these cells, which are the most important defence mechanism of the body, the entire immune system of the body gets affected and the immunity power of the body gradually decreases. Because of this, the organisms, which cannot infect a healthy normal person, are easily able to infect a person suffering from AIDS.

How the AIDS spreads?

1.        By heterosexual or homosexual intercourse. 2. Transfusion of the blood of an AIDS patient to a normal person.

 

2.        Mothers suffering from HIV can transmit the disease to her fetus during pregnancy in 30 to 40% of the cases.

3.        By the needle of the injection, syringe and other operative instruments.

4.        If a normal person uses a needle used by an AIDS person, addicted to intravenous drug abuse, the infection can easily spread.

5.        There are many misconceptions that are still prevalent in our society regarding AIDS. For example, AIDS can be transmitted by staying with a patient, shaking hands, playing, eating etc. All these notions are only myths. It is very necessary that an AIDS patient is not isolated but socially accepted with warmth.

Tips for prevention of AIDS

1.        Disposable syringes and needles should be used for injections and injections should be avoided for common diseases unless absolutely essential.

2.        Don’t have sexual relations with a stranger.

3.        If blood transfusion is required the blood should be used only after testing the blood for HIV in a laboratory. If possible take blood only from family members and relatives. Don’t take blood from professional blood donors.

4.        Use individual razors and blade and avoid sharing.

 

Symptoms of AIDS :

1.        The first illness occurs within 6 to 8 weeks. The patient gets fever, muscular pain, swelling of lymph glands, red spots on the skin, swelling in the throat etc. The patient is cured without any treatment in a week. This first illness is called as sero conversion illness. After this first illness HIV test is positive. In the initial 6 to 8 weeks the laboratory test is negative but the patient can still spread AIDS during this phase. This phase is called Window period.

2.        After the first illness, the patient enters the non-symptomatic HIV carrier phase. This phase can last up to 5 to 10 years. This period is dependent on the overall health and habits of the patient.

3.        After this phase various symptoms are seen like swelling of the lymph glands, continuous or frequent fever, ulceration in the mouth and throat, splenomegaly, prolonged coughing, weight loss etc. If these symptoms prevail for a long period of time or recur frequently, diagnosis can be confirmed by getting the blood tested for HIV. If the ELISA test for HIV is positive, this test is repeated once again and if this too is positive, the findings are confirmed with an investigation called western blot test The diagnosis can also be confirmed by P.C.R. test, virus load etc. CD4 count helps to determine the strength of the immune system of the body. If the count is less than 100, it is assumed that the patient is near death.

 

The main symptoms of HIV as defined by the World Health Organization : “WHO”

1.        Fever for over a month

2.        Diarrhoea for over a month and weight loss of more than 10%.

3.        Coughing, itching in the body, ulceration in the mouth, throat or private parts of the body, swelling of the lymph glands in two or three parts of the body, frequent attacks of herpes zoster, signal a HIV test to be done.

Various neurological symptoms related to the brain and nervous systems are found in AIDS. It is said that 33% of the patients suffering from AIDS have an overt neurologicaldisorder, while actually the brain and nerve tissues are more or less damaged in every AIDS patient.

Laboratory Investigations: /Pathological tests :

The presence of the HIV organisms in the body is detected with the help of ELISA test. This test is a screening test and if it is positive, confirmation is done with the help of Western Blot test. After infection, one is able to detect the presence of HIV in a period of 6 weeks to 6 months through these tests. But during the window period this test can be negative or indeterminate results. The number of viruses present in the body and CD 4 count can also be determined through various tests, which is helpful for the treatment.

 

The diseases of the brain and the nervous system related to AIDS are divided into five parts


1.        Brain encephalitis, herpes simplex, varicella zoster, AIDS dementia complex (memory disorder), diseases of the metabolism of the brain, TB of the brain, lymphoma, toxoplasmosis, P.M.L, abscess, syphilis of the brain, fungal infection of the brain etc. can cause extensive damage, by direct infection of brain.

2.        Edema of the spinal cord called myelitis, myelopathy etc. can occur, which can hamper the movements of the patient.

3.        Infections in the membranes of the brain (meningitis) resulting in meningitis. These infections can be due to organisms of TB, syphilis, fungus, and can cause unconsciousness, seizures or paralysis.

 

4.        Damage to the nerves of the nervous system result in neuritis caused by infectious organisms like Herpes etc. This may result in burning sensation in the legs, walking disability, pain etc.

5.        Polymyositis and other such muscle related diseases in which the muscles become weak.

Therefore, AIDS can cause disorders in organs ranging from the lymph glands to neurological system, though diseases related to the heart are seen in less proportion in AIDS patients.


Treatment :

The treatment of AIDS is usually long term and very expensive. Still the treatment, which can cure AIDS completely, has not yet been discovered. With the present medicines and the treatment it is only possible to stop the spread of the disease as well as improve the immune system (CD4 count) to some extent. As a result the quality of the patients life can be improved, the infectious diseases can be prevented and the patient can move around and can remain mentally sound.

The medicines available to kill the AIDS virus are very expensive. Many a times the doctors use a combination of three medicines whose average monthly expense is around Rs. 10,000/-. The irony is that in spite of this expenditure, the disease is neither completely cured nor controlled.

It is to be remembered that the infection of HIV is not the primary cause of death. The AIDS patient dies mainly because of the infections of microorganisms and infectious agents. Therefore, if the diagnosis of these organisms is done in an early stage and treated immediately these infections can be cured. However, treatment of AIDS is now more or less a separate medical sub-speciality and for all further details an AIDS specialist should be consulted.

In short, early diagnosis, appropriate treatment, a healthy lifestyle which prevents infections and infectious diseases, can improve the life and the quality of life of the patient of AIDS.

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