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What is HIV-Associated Brain Impairment, and how does Mildmay help?

A black and white anatomical drawing of the human brain

Mildmay specialises in the treatment of HIV-Associated Neurocognitive Disorder, or HAND*, impairment caused by HIV entering and affecting the brain.

This is a form of severe dementia that Mildmay is able to curtail or even reverse in the majority of our patients, enabling them to return to some form of independent living. People with HAND often display symptoms that are very similar to dementia, such as memory loss, confusion, loss of a sense of self, and difficulty in walking, speaking or carrying out everyday tasks. Mildmay’s specialised treatment, care and rehabilitation include highly skilled medical and nursing care, treatment, rehabilitation and a combined range of therapies.


*HIV-associated neurocognitive disorders are neurological disorders associated with HIV infection and AIDS. It is a syndrome of progressive deterioration of memory, cognition, behaviour, and motor function in HIV-infected individuals during the late stages of the disease when immunodeficiency is severe.

HAND may include neurological disorders of varying severity. HIV-associated neurocognitive disorders are associated with a metabolic encephalopathy induced by HIV infection and fuelled by immune activation of macrophages and microglia. These cells are actively infected with HIV and secrete neurotoxins of both host and viral origin.

The essential features of AIDS dementia complex (ADC) are disabling cognitive impairment accompanied by motor dysfunction, speech problems and behavioural change.

Cognitive impairment is characterised by mental slowness, trouble with memory and poor concentration. Motor symptoms include a loss of fine motor control leading to clumsiness, poor balance and tremors.

Behavioural changes may include apathy, lethargy and diminished emotional responses and spontaneity.


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