Dear Dr. Currier,

First of all, thank you for all your help to us all! My husband is 26, t-cell count of 47, viral load of 185,000 and just started therapy of viracept, zerit, and epivir 3 weeks ago. Over the past year, I have been noticing him forgetting things here and there, and sometimes having slowed thinking over things that he normally is quick on, i.e. he was a math major at Harvard and sometimes he is slow on basic math problems. He occasionally experiences a head pain only when he coughs which is located in the lower back right of his head. Are these the beginning symptoms of a brain infection, or are these just normal things that we all experience that my paranoia is blowing out of proportion?

Please help me quell my nerves.

worried wife

Dementia may be subtle in HIV+s, but diminished concentration and ability to do calculations are very typical symptoms. Neither dementia nor PML are associated with head/neck pain, and I suspect that may be a separate problem. He should be thoroughly evaluated for his symptoms, with a complete physical exam and tests such as an MRI or CT brain scan, neuropsychological tests, and possibly a spinal tap to find out what's going on. Both dementia and PML have been reported to improve when combination HIV therapy strengthens the immune system.