Dementia associated with human immunodeficiency virus (HIV dementia) has been reported in HIV-infected patients. HIV-retrovirus plays an important role in the pathogenesis of the syndrome. A number of indirect factors generated by infected macrophages may contribute to the pathogenesis of HIV dementia. Inflammatory cytokines and mediators damage neuronal cells, with a subsequent loss of cognitive functions. Also Gp120, an HIV surface antigen, and Vpr protein can cause neuronal death via apoptosis. Activation of NMDA receptor s is the final common pathway both in HIV dementia and in other neurodegenerative processes. Antiretroviral therapy protects against neuropsychological deficits and clinical manifestation of dementia.