Another Kind of AIDS Crisis

A striking number of HIV patients are living longer but getting older faster—showing early signs of dementia and bone weakness usually seen in the elderly. this article reprinted from NYMag

When David Simpson was working at Mount Sinai Medical Center as a young neurologist in 1984, the neuro-AIDS program occupied a dark warren of tiny rooms in the complex’s basement. It was a place overwhelmed by plague, a final stop on a doomed journey. “People came in with seizures or paralyzed on half their body. People came in in comas. Men were screaming—I have videotapes of this,” says Simpson, the program’s director. “Bedbound, incontinent, couldn’t sleep. They could be dead in a number of days.”

Those are memories of a distant past. When the drugs arrived in 1996, they ended this kind of pitiless death and put many AIDS wards out of business. The famous St. Vincent’s seventh-floor ward now houses offices for the orthopedic department. The sixth floor at New York Downtown, the eleventh floor at Beth Israel, the seventeenth floor at New York-Cornell, whole wings at Lenox Hill, Bellevue, and Harlem hospitals—those dire corridors where, in a little over ten years, more than 60,000 New Yorkers drew their last painful breaths—have been cleared out and repurposed. “So much trauma, there was so much history,” says Victoria Sharp, who directed AIDS programs at Beth Israel, St. Clare’s, and St. Luke’s-Roosevelt, “and they’re gone.” Simpson stayed in business by expanding into other areas of neurological research (using Botox to help treat stroke paralysis, for one).

But in the last year or so, doctors have been troubled by the emergence of a new kind of AIDS story. Take the case of James L., 46. After testing positive in 2001, he went on a drug cocktail and life returned to normal with little effort. His exercise regime only intensified. He even went back to school for a master’s degree. At work, he rose to a six-figure position at a telecommunications firm, and his personal life flourished. He was, he told me, “a regular gay male.”


Then, halfway through a screening of the film Syriana in his local cinema, he had a disturbing revelation. “He sat through about half the movie before he realized suddenly that he had seen the same movie two weeks earlier,” says Simpson. Indeed, James ultimately pieced together evidence suggesting he’d seen the film on three separate occasions. The same problem haunted him at work. Where he had once earned praise for his organizational skills, he now drew warnings. He seemed incapable of recalling recent events with any reliability. “It’s an Alzheimer’s-like state,” he explains. Earlier this year, Simpson diagnosed him with HIV-associated cognitive motor disorder.

read the rest of the story after the jump

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