Acceleration of HIV dementia with methamphetamine and cocaine

A. Nath, W. F. Maragos, M. J. Avison, F. A. Schmitt, J. R. Berger

Research output: Contribution to journalArticlepeer-review

142 Scopus citations


We report a patient with rapidly accelerating HIV dementia accompanied by seizures and an unusual movement disorder despite highly potent antiretroviral therapy. This clinical constellation was associated with the non-parenteral use of methamphetamine and cocaine. Fractional enhancement time on post contrast magnetic resonance imaging studies revealed a progressive breakdown of the blood brain barrier particularly in the basal ganglia. The movement disorder but not the dementia responded to a combination of dopamine replacement and anticholinergic therapy. While the movement disorder may have been unmasked by concomitant anticonvulsant therapy, we suggest in this instance, that prior drug abuse synergized with HIV to cause a domino effect on cerebral function. Careful attention and analysis to histories of remote non-injecting drug abuse may help substantiate our hypothesis.

Original languageEnglish (US)
Pages (from-to)66-71
Number of pages6
JournalJournal of neurovirology
Issue number1
StatePublished - 2001


  • AIDS
  • Brain
  • Cocaine
  • HIV
  • Methamphetamine

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Virology


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