A new study by Kaiser Permanente’s research division has shown that people with HIV are significantly more likely to develop dementia if they started antiretroviral therapy (ART) when their CD4 cell count — a marker of immune system strength — was already significantly reduced.
In an article published in Open Forum Infectious Diseases, scientists analyzed the medical records of more than 21,000 patients aged 50 and older who received HIV treatment between 2000 and 2023 and found that those who started ART with low CD4 counts were diagnosed with dementia 33% more often than those who started therapy earlier. Even if CD4 counts improved after starting treatment, the increased risk did not disappear completely, indicating the long-term consequences of delaying the start of therapy.
In the sample, which was followed for an average of seven years, 618 individuals were diagnosed with dementia, including Alzheimer’s disease, vascular dementia, and other types of cognitive impairment.
The authors emphasize that these results confirm the importance of timely HIV detection and immediate treatment, as earlier initiation of ART may reduce the risk of cognitive problems in old age. The researchers also note that the risk of dementia is determined by many factors, including lifestyle and genetics, but timely treatment is one of the modifiable factors that can be influenced.
Scientists at Weill Cornell Medicine have discovered new genetic markers that may explain why many people living with HIV, even with good viral control, experience problems with memory, attention, mood, and movement.