Memory problems

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Forgetfulness, or difficulty in remembering or recalling facts, are symptoms that many people with symptomatic HIV infection report. Often they accompany symptoms of stress, moodiness, anxiety and depression but are more serious if associated with odd behaviour, personality change, disorientation, fits or problems with walking.

Causes

Many people can be forgetful, especially at times of stress or anxiety, but if the problem is progressive and severe or associated with other cognitive (thinking) problems then this could be due to either HIV-associated dementia, CMV encephalitis or severe depression. Opportunistic infections (such as toxoplasmosis) or tumours (such as lymphomas) which affect the brain can cause and contribute to memory and mental problems and should be excluded first. The sexually transmitted infection, syphilis, can affect the brain causing neurological symptoms. Drugs, especially benzodiazepines (Valium, temazepan), tranquilisers and alcohol can also be factors.

Some anti-HIV drugs, most frequently efavirenz, have also been associated with memory problems, forgetfulness and a spaced-out feeling, especially during the first few weeks of treatment. In most people the memory problems improve after a few weeks as the early side-effects of efavirenz go away. In cases where these side-effects are particularly severe, some doctors have used an anti-psychotic drug called haloperidol to help people cope during the first weeks or months of taking efavirenz.

In people with asymptomatic HIV infection, significant neurocognitive problems such as the features of dementia usually do not occur.

What to do

If there are concerns about memory or other mental problems, these need to be discussed with a doctor. Investigations may need to be undertaken to exclude opportunistic infections or tumours. A psychologist may use tests to assess the problem and help to decide whether depression and anxiety are contributing. Assumptions that memory problems are all related to HIV-associated dementia should not be made until other causes have been investigated, excluded or treated. Decisions about work and advice on how to cope with the practical problems of cognitive impairment will then need to be considered with the help of counsellors, doctors and carers.

AZT is a highly effective treatment for memory problems caused by the direct effects of HIV. HIV-associated dementia is now extremely rare among people who are currently taking combinations that include AZT, even in advanced HIV infection.

See also: Depression and HIV-associated dementia in A to Z of illnesses.

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap
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This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

NAM’s information is intended to support, rather than replace, consultation with a healthcare professional. Talk to your doctor or another member of your healthcare team for advice tailored to your situation.