HIV Infection Comorbid with Psychiatric Disorders: Five Case Reports

Abstract

Acquired immune deficiency syndrome (AIDS) is a neuromedical disorder associated with infection by virus of the retroviridae class known as human immunodeficiency virus (HIV) [1]. Acquired immunodeficiency syndrome (AIDS) which is a global pandemic, was first identified in 1981 and by 2009 it has led to nearly 30 million deaths. Homosexual men are the largest risk group for HIV infection and constitute about two- thirds of the reported cases in the United States. In African countries heterosexual transmission is more common. The next largest group is injection drug users. Heterosexual persons infected sexual intercourse, new-borns infected via placental transmission, and recipients of HIV-contaminated blood transfusions, including persons with haemophilia make up the rest. According to the data of Turkish Ministry of Health and Social Services in 2012 there were total of 5740 cases (Male: 4093, Female: 1635, Unknown: 12). 1024 of the cases were AIDS disease and 4716 HIV seropositive [2].The distribution of etiology during 2012 is as follows: The total number of HIV cases is 1024. Heterosexual persons infected sexual intercourse are 368 (35.9%); unknown etiology is 500 (48.8%); homosexual persons infected sexual intercourse are 136 (13.3%); new-borns infected via placental transmission are 11 (1.1%); injection drug users are 6 (0.6%); recipients of HIV-contaminated blood transfusions are 3 (0.3%). In central nervous system infection of cells primary astrocytes is responsible for neuropsychiatric manifestation. Recent medical advances have begun to alter natural progression of the illness from one of the accelerating deterioration to more chronic course. Many studies have been done to know prevalence of psychiatric morbidity in HIV positive patients and they found high psychiatric morbidity that ranged from 4-60% [3-11]. Among all psychiatric morbidity, depression is one of the most common psychiatric disorders. Depression is 2-4 times more prevalent in HIV in comparison to general population [12-15]. Discovery of the infection has a dramatic psychological impact on the patient, as does the disease relentless progression. The neurotropic of virus itself produces neuropath logical changes in deep grey structure whose dysfunction is known to cause depression. Depression often goes undiagnosed and untreated. As many as one in three persons with HIV may suffer from depression. Mario Maj (1990) [16] and Ayuso Mateo (2002) [17] also support this fact that the dramatic psychological impact of the discovery of the infection causes acute stress reaction. Mario Maj (1996) [18] reported that the possible effects of the cognitive impairment related to HIV infection of the brain (psychomotor slowing, forgetfulness and difficulties in concentration are early symptoms of this impairment) may inflate estimates of depression in HIV infected people.