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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Human immunodeficiency virus (HIV) frequently enters the central nervous system (CNS) soon after infection, and frequently produces a wide variety of neurologic, cognitive, and psychiatric complications. Although, the entire spectrum of psychiatric illnesses may be seen in individuals with HIV infection, most are probably not directly caused by the virus. Psychiatric manifestations that are the direct result of HIV infection are usually seen in the setting of HIV-associated dementia. In this paper, it is proposed that these psychiatric manifestations of HIV infection can be phenomenologically separated into positive and negative symptoms. Negative symptoms are deficit states presenting as cognitive, social, or motivational deterioration; positive symptoms are psychotic or manic states that may occur in the course of the dementing illness. It is further purposed that there is a window of vulnerability to psychosis or mania that occurs relatively early in the dementing process. Consequently, advancing dementia would be expected to be associated with remission of psychosis.
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PMID:AIDS dementia-related psychosis: is there a window of vulnerability? 149 45

Cases of mania associated with acquired immune deficiency syndrome (AIDS) are reviewed in an attempt to elucidate patterns that may be helpful in guiding treatment, determining prognosis, and understanding pathophysiology. Fourteen well-described cases in the English language literature were critically reviewed. Data was collected regarding chronological appearance of signs and symptoms, specific psychiatric symptoms, associated neurologic and cognitive function, objective testing of brain structure and function, and outcome. When mania or hypomania occur in the setting of a human immunodeficiency virus (HIV) infection, it frequently occurs once and does not recur. AIDS-associated manic states are adequately responsive to available antimanic agents, however, AIDS patients may be more prone to deleterious side effects. Although mania or hypomania may be the presenting complaints that lead to the discovery of human immunodeficiency virus (HIV) seropositive status, mania tends to occur in people exhibiting signs of immunodeficiency as is exemplified, in the sample, by death occurring within six months of the psychiatric presentation in nearly a quarter of the patients. It is hypothesized that AIDS-related mania and agitated psychosis may be related to increased intracellular free calcium.
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PMID:Mania in AIDS: clinical significance and theoretical considerations. 177 29

A retrospective review of the records of 755 patients seen by a psychiatric consultation-liaison service in a general hospital was performed. The authors found that 87% of manic patients and 38% of depressed patients had a diagnosis of organic mood disorder. The most frequent precipitants of mania were corticosteroids, human immunodeficiency virus (HIV) infection, and temporolimbic epilepsy. The most frequent precipitants of depression were stroke, Parkinson's disease, and HIV infection.
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PMID:Causes of organic mood disorder. 252 Oct 90

The AIDS Dementia Complex (ADC) frequently occurs in individuals with Acquired Immunodeficiency Syndrome (AIDS). We report on a clinical series of 33 patients with either AIDS or AIDS-Related Complex (ARC), who were referred for neuropsychological evaluation. This clinical series supports the developing understanding that AIDS spectrum patients often demonstrate impairment on tasks involving abstract reasoning, memory, speeded mental processing and motoric slowing. This series helps to draw attention to a small subgroup of patients, with no previous psychiatric history, who after infection with the human immunodeficiency virus (HIV), present with hyperactivity, euphoria and grandiose delusions. ADC would appear to bear with it the increased possibility of the development of secondary mania.
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PMID:Neuropsychiatric aspects of AIDS dementia complex: a report on a clinical series. 320 May 6

The potential for secondary (biological or psychological) mood disorders would seem to be heightened in human immunodeficiency virus (HIV) for many reasons. HIV infection is associated with lethal, multisystem illness related to profound immune dysregulation; infection involves the central nervous system (CNS) shortly after infection and leads to substantial neurocognitive impairment even in the absence of other physical evidence of disease. Psychological forces at work include social stigimitization of unparalleled proportion for the modern era, combined with bereavements of epidemic proportions, Nevertheless, it is misleading to attribute to HIV itself-or to its psychological and social consequences-all episodes of mood disorder. Preinfection rates of major depression are high in groups at greatest risk for HIV. Rates of "current" major depression approach 10%, but perhaps 50% of affected individuals have preinfection evidence of mood disorder. Mania is relatively rare, with an overall prevalence less that 1%. "Subsyndromic" mood disorder is understudied, but may effect an important minority of individuals. Given current advances in neuromedical evaluation, neuropsychological assessment, and rigorous psychiatric criteria, it is likely that study of secondary mood disorders in HIV can contribute to important advances in our understanding of brain-behavioral relationships.
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PMID:Mood Disorder Due to Human Immunodeficiency Virus: Yes, No, or Maybe? 1032 Apr 71

Patients infected with human immunodeficiency virus, type 1, may present with neuropsychiatric manifestations across all stages of disease. Frequently, these patients may present with more than one neuropsychiatric disorder concomitantly. The case presented highlights the utility of detailed clinical observation, careful use of medical terminology, and a neuropsychiatric organizing paradigm in the diagnosis and treatment of a patient presenting over time with delirium, aphasia, mania, and a complex partial seizure disorder.
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PMID:The role of precise conceptualization in the treatment of a complicated HIV-1-infected neuropsychiatric patient. 1033 94

A case-control study of 19 patients with HIV-associated mania and 57 HIV-seropositive control patients matched by CD4 cell count, age, and year of treatment was undertaken to investigate associations with risk factors for human immunodeficiency virus (HIV) infection, treatment, and disease. There was no significant difference between groups for HIV exposure category, baseline health status, or drugs other than antiretrovirals. Zidovudine therapy provided a significant protective effect against the development of mania, whether administered at or prior to diagnosis of mania. In a 3-year follow-up study, incident AIDS dementia was significantly more common in patients with mania, despite no apparent difference in survival between cases and controls. These findings strengthen the evidence of an etiological association of HIV neuropathology with AIDS mania by demonstrating a protective effect of an antiretroviral agent able to penetrate the central nervous system.
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PMID:Secondary mania in patients with HIV infection: are antiretrovirals protective? 1057 Jul 61

Human immunodeficiency virus seropositive (HIV+) individuals are at a heightened risk of developing mood disorders and related syndromes. Over the past several decades, increased rates of mood disorders, including depression and mania, have been reported among HIV+ individuals. Because alterations in mood may impact on quality of life and perhaps reduce adherence to antiretroviral treatment regimens that are critical for preventing disease progression, recognition and effective treatment of mood disorders is essential. There are accumulating data showing that antidepressants and mood stabilizers, as well as other novel agents, might benefit HIV+ individuals suffering from a concomitant mood disturbance. This review highlights the relevant studies that have examined prevalence rates of mood disorders in HIV+ individuals, characteristics of HIV disease that influence the diagnosis and psychopharmacologic treatment of mood disorders, including complex interactions with antiretroviral medications, as well as the available evidence regarding the efficacy of agents used to treat depression and mania in the context of HIV disease.
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PMID:Prevalence, diagnosis, and pharmacological treatment of mood disorders in HIV disease. 1289 6

Neuropsychiatric complications of human immunodeficiency virus (HIV) infection or acquired immune deficiency syndrome (AIDS) may present clinically as acute or chronic organic brain syndrome, or mimic functional psychiatric diseases. Among such psychiatric diseases, mania tends to occur with increased frequency after the onset of AIDS. We report a case in which manic manifestations were noted before the diagnosis of AIDS. The patient had no past or family history of mood disorders, but had risk factors for HIV infection. He had a rapid downhill course from initial manic symptoms to depression, dementia and then death within 10 months. Such rapid cognitive deterioration into AIDS dementia after mania is consistent with previous reports. Cases like this will become more common with spread of the AIDS pandemic in Asian regions, including Taiwan. Clinicians should be mindful of HIV infection/AIDS as a differential diagnosis in patients with manic episodes and risk factors for HIV infection.
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PMID:Association of AIDS and bipolar mania with rapid progression to dementia and death. 1575 22

Antiretroviral therapy has revolutionized the treatment of the human immunodeficiency virus because it has improved the clinical outcomes of patients. It is essential that these drugs cross the blood-brain barrier, since the virus is present in the central nervous system (CNS). Efavirenz passes through this barrier satisfactorily and can reduce the deleterious central effects of the human immunodeficiency virus. However, patients treated with efavirenz have been observed to experience psychiatric symptoms such as mania, depression, suicidal thoughts, psychosis, and hallucinations. The aim of this review is to describe the pharmacokinetic and pharmacodynamic properties of efavirenz and its major neuropsychiatric symptoms and the neurochemical pathways associated with these changes in the CNS. The databases Medline and Lilacs were used to search for review articles and preclinical and clinical research articles published from January 1996 to 2010. The search terms used were efavirenz, central nervous system, neuropsychiatry, neurotransmitters, adverse effects, and neurochemistry. Subject categories considered included effects on viral replication, pharmacokinetic and pharmacodynamic properties of efavirenz, and neuropsychiatric adverse effects including time course, duration, and probable mechanisms involved. The mechanisms involved in these changes include interference with cytochrome P450 enzymes, cytokines, tryptophan-2-3-dioxygenase, and brain creatine kinase.
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PMID:Implications of efavirenz for neuropsychiatry: a review. 2096 56


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