Now on to #10 of the 25 things you should know about HIV (and probably don’t). These 25 things will impact what you do and the choices you will make.
“A good retreat is better than a bad stand.” ~Irish saying
#10: HIV can retreat to places the immune system cannot follow like your brain.
HIV can cross the brain-blood barrier (move from your blood to your brain), infecting cells in your nervous system. Most immune cells cannot cross that barrier, which surrounds the brain and spinal cord, so HIV can retreat where the immune system can’t follow. It enters the brain soon after initial infection – typically within the first several days – but doesn’t cause significant damage right away.
HIV in the brain doesn’t go after your neurons, those important brain cells responsible for transmission of electrical impulses that control the body. Instead, it goes after other cells that have long lives. Once inside these long-lived cells, HIV can stay in a latent state for an extended period of time.
Rather than directly killing brain cells – as it does with CD4 T-cells elsewhere in your body – HIV affects your brain by setting off a cascade of damages through inflammation and oxidative stress caused by free radicals..
Why is this important to you?
The damage that HIV causes to your brain and to your central nervous system can impair your neurocognitive functions. That can bring on symptoms such as poor attention, memory lapses, and mood changes.
Understanding what your viral load is in your cerebrospinal fluid (CSF) as well as your blood plasma is something to consider this when working with your doctor on your treatment regimen. Some antiretroviral drugs are better than others in crossing the blood-brain barrier and they can impact your CSF viral load.
Reducing your viral load in the plasma and CSF may be necessary to reduce neurocognitive impairment, but it will not halt all the inflammatory responses or completely undo the damage caused by HIV’s march on the brain.
While effective antiretroviral treatment and recovery of your immune system dramatically reduce the occurrence of these complications in your brain and severe HIV-related dementia, mild-to-moderate impairment of your neurocognitive and motor functions is still a concern even with treatment.
How does this affect your path?
There seems to be a never ending flow of information that you have to know to keep up with HIV. Choosing to be a full partner in your treatment and understanding all you can about how HIV affects your body is going to be a huge decision for you.
Battles have to be waged on many fronts to deal with HIV in your body. HIV is not just a disease of your immune system – it affects many of your major organs.
It will have to be your choice to stay on top of what is happening in your body and what is happening with your treatment. While it may seem that HIV has taken away some of your choices, it has presented you with a whole set of new ones.
“Every man builds his world in his own image. He has the power to choose, but no power to escape the necessity of choice.” ~Ayn Rand