Secondary mania in patients with HIV infection: are antiretrovirals protective?

J Neuropsychiatry Clin Neurosci. 1999 Fall;11(4):475-80. doi: 10.1176/jnp.11.4.475.


A case-control study of 19 patients with HIV-associated mania and 57 HIV-seropositive control patients matched by CD4 cell count, age, and year of treatment was undertaken to investigate associations with risk factors for human immunodeficiency virus (HIV) infection, treatment, and disease. There was no significant difference between groups for HIV exposure category, baseline health status, or drugs other than antiretrovirals. Zidovudine therapy provided a significant protective effect against the development of mania, whether administered at or prior to diagnosis of mania. In a 3-year follow-up study, incident AIDS dementia was significantly more common in patients with mania, despite no apparent difference in survival between cases and controls. These findings strengthen the evidence of an etiological association of HIV neuropathology with AIDS mania by demonstrating a protective effect of an antiretroviral agent able to penetrate the central nervous system.

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Atrophy / diagnostic imaging
  • Atrophy / pathology
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / etiology*
  • Bipolar Disorder / prevention & control*
  • Brain / diagnostic imaging
  • Brain / pathology
  • CD4 Lymphocyte Count
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • HIV Seropositivity / drug therapy*
  • HIV Seropositivity / psychology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed
  • Zidovudine / therapeutic use*


  • Anti-HIV Agents
  • Zidovudine