byline: Larry: This is your brain on HIV and HCV.

byline: Larry: This is your brain on HIV and HCV.: "There was tough news out of the 2011 Conference on Retroviruses and Opportunistic Infections (CROI) concerning HIV and the brain. In t..."

This is your brain on HIV and HCV.

There was tough news out of the 2011 Conference on Retroviruses and Opportunistic Infections (CROI) concerning HIV and the brain.  In the study, HIV was found in the brains of all participants.  There is a strong belief among researchers that HIV causes systemic inflammation.   HIV damage in the brain appears in the second and third of the four stages (Freiberg Stages) prior to seroconversion to AIDS, when there is a peak in inflammation.  Brain changes were demonstrated as early as two months into infection, usually before seroconversion.  While the changes are subtle, cognitive function declined as much as 13% in the first year and 35% in the second.  Much of this brain harm is associated with <350 T4 helper count and increased inflammation.  The good news is that age and length of infection are not associated with cognitive decline.

Apropos to that, a Canadian research team at the University of Montreal believes they’ve found a long elusive reservoir where HIV hides out.  It has been a long held theory that it might be the brain, but viral levels in the cerebral-spinal fluid are significantly lower than that found in the brain. That doesn’t disprove the brain reservoir theory.  It is an indication, however, that the theory could be flawed. The Canadians believe they’ve discovered a true reservoir in certain long term immune system memory cells.  These cells tend to hang around sleepily for a very long time, activating only when they encounter an old foe, such as the mumps or measles.   

In HCV, cognitive implications were identified early on mostly by patients who termed it “brain fog”, describing the come and go disorientation and confusion they experience.  It is a condition associated with HCV that tends to worsen over time. It becomes especially problematical with such complications as hepatic stents (essentially, an in-liver bypass), asciites, and other associations where toxins build in the blood.  A distinction was, at one time, drawn between brain fog and hepatic encephalopathy (HE) as was noted in an HCVAdvocate article as far back as 2002.  Today, however, it appears that the only real distinction is in severity.  It’s noteworthy that patients view brain fog in an almost humorous manner, but hepatic encephalopathy is nothing to joke about.  Hepatitis-Central posts an extensive overview in very simple format that may be helpful for those dealing with any stage of HE. 

Researchers already knew that HCV affects the brain.  New studies show that even when serious liver damage hasn’t occurred, patients still suffer memory loss, have trouble concentrating, apathy, and depression.  HCV gets in the brain where it infects and replicates.  A build up of HCV proteins in the cell eventually kills it, drowning it in its own refuse, so to speak.  U.S. Centers for Disease Control and Prevention picked up this study from Canadian researchers and The Body issued a report on it last October. 

We know that the brain is a wondrous entity.  It has an uncanny ability to work around deficits and injuries if it’s taught to do so.  Look at Representative Gabrielle Giffords.  She took a high caliber bullet through her brain in January.  It is now April and she’s singing Twinkle, Twinkle Little Star, talking on the telephone, and making noises about running for the senate next time.  That’s completely awesome.  And we know some really cool strategies for exercising the brain so that we might avoid Alzheimer’s.  Those methods work.  They can divert Alzheimer’s completely, or delay its onset. 

Could it be that brain implications are cross dimensional regardless of the underlying disease or injury that cause them?  It begs the question, Are there strategies that might aid in at least slowing the rate of mental deterioration found in both HIV and HCV, separate disorders that share many similarities?  There are very long term survivors of HIV/AIDS who must have suffered HIV infection in the brain very early in the disease process.  Some are completely nuts, but most of us function fairly normally in society.   How do we determine why that is and if it can be applied to disease across a spectrum?

Living itself is like a virus.  It kills brain cells.  Given enough time there will be cognitive decline.  Deep research into this barely addressed phenomenon might bring positive results not only for those who suffer.  Would doing crosswords or learning a new language open heretofore unseen pathways to good brain health, and does anyone know a four letter word meaning ‘mentally competent”?