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Common HIV Drug May Lead to MemoryProblemsHome News Work and Career News Common HIV Drug May Lead to Memory Problems

By Traci PedersenAssociate News EditorReviewed by John M. Grohol, Psy.D. on October 3, 2012

Efavirenz, a commonly prescribed anti-retroviral drug typically

used long term by HIV patients, may lead to cognitive impairment,

suggests a new Johns Hopkins study.

For a long time, it was assumed that the disease was causing

cognitive damage, but Hopkins researchers say efavirenz may be

the culprit. Almost half of those individuals with HIV eventuallydevelop some form of brain damage that, although mild, can make

it harder to drive, work or participate in everyday activities.

People with HIV are typically prescribed a variety ofmedications

to suppress the virus, and many take the drugs for decades. As

one of the few effective drugs that can cross the blood-brain

barrier, efavirenz is able to target potential reservoirs of virus in the

brain.

Doctors have long thought that it might be possible to minimize cognitive problems associated with HIV

by getting more drugs into the brain, but researchers say more caution is needed because of these

long-term effects.

People with HIV infections cant stop taking anti-retroviral drugs. We know what happens then and its

not good, said Norman J. Haughey, Ph.D., leader of the study and associate professor of neurology at

the Johns Hopkins University School of Medicine.

But we need to be very careful about the types of anti-retrovirals we prescribe, and take a closer lookat their long-term effects. Drug toxicities could be a major contributing factor to cognitive impairment in

patients with HIV.

For the study, samples of blood and cerebrospinal fluid were drawn from HIV-infected patients who

were taking efavirenz. Researchers looked for levels of the drug and its various metabolites, which are

substances created when efavirenz is broken down by the liver.

Haughey and his team found that one of these metabolites, called 8-hydroxyefavirenz, is 10 times more

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toxic to brain cells than the drug itself. Even at low levels, this metabolite causes damage to the

dendritic spines of neurons. The dendritic spine is the information-processing point of a neuron.

Namandje N. Bumpus, Ph.D., one of the studys authors, found a way to modify the drug to prevent it

from metabolizing into 8-hydroxyefavirenz while still maintaining its ability to suppress the HIV virus.

Finding and stating a problem is one thing, but its another to be able to say we have found this

problem, and here is an easy fix, said Haughey.

Haughey says that this type of research serves as a reminder that although individuals infected with HIV

are living longer than they were 20 years ago, they still encounter significant problems from the drugs

used to treat the infection.

Some people do seem to have this attitude that HIV is no longer a death sentence, he said. But even

with anti-retroviral treatments, people infected with HIV have shortened lifespans and the chance of

cognitive decline is high. Its nothing you should treat lightly.

The research is found in the Journal of Pharmacology and Experimental Therapeutics.

Source: Johns Hopkins Medicine

APA Reference

Pedersen, T. (2012). Common HIV Drug May Lead to Memory Problems. Psych Central. Retrieved on

October 3, 2012, from http://psychcentral.com/news/2012/10/03/common-hiv-drug-may-lead-to-

memory-problems/45478.html

http://www.hopkinsmedicine.org/