Note: I was introduced to this topic by Gene Dronek, who has been studying it for several years. I find the arguments below to be very compelling. However, I have no formal credentials in biology or medicine. So, I encourage you to dig into the HAND page and let me know if I've gotten anything substantive wrong.


Although some points are under dispute, most scientists have reached a rough consensus about Acquired Immunodeficiency Syndrome (AIDS). For example:

  • It manifests as a low concentration of T cells (i.e., T lymphocytes) in the blood.

However, this consensus is markedly, and dangerously, incomplete. Specifically, it fails to account for the biological mechanisms involved in HIV Associated Neurocognitive Disorders (HAND). As a result, patients are being given inappropriate amounts and kinds of medication.


In order for HIV to cause HAND, the virus must pass through the blood-brain barrier (BBB). Once there, it can cause damage to the central nervous system. It can also replicate, pass back across the barrier, and reinfect the rest of the patient's circulatory system.

In order to fight brain-resident HIV, the antiviral therapy must also be able to pass through the blood-brain barrier. Unfortunately, some of the more popular drugs in current use do this very poorly or not at all. This gives the virus a "safe area" where it can replicate, reinfect the patient, and (not incidentally) cause damage to the CNS.


If the biological mechanisms involved are behaving as described above, several plausible conclusions can be drawn:

  • The concentration of [[https://en.wikipedia.org/wiki/T_cell][T cells] in the rest of the body may not be well correlated with that in the CNS. So, it is not reliable as a predictive tool, proxy, etc.

  • The ability of antiviral drugs to pass through the blood-brain barrier needs to be evaluated and publicized to clinicians.

  • Antiviral drugs need to be prescribed at a level which compensates for the difficulty of passing through the blood-brain barrier.

To be continued...

This wiki page is maintained by Rich Morin, an independent consultant specializing in software design, development, and documentation. Please feel free to email comments, inquiries, suggestions, etc!

Topic revision: r38 - 06 Jul 2015, RichMorin
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