JOURNAL ARTICLE
REVIEW

Neurologic Complications of Human Immunodeficiency Virus Infection

Avindra Nath
Continuum: Lifelong Learning in Neurology 2015, 21 (6 Neuroinfectious Disease): 1557-76
26633776

PURPOSE OF REVIEW: Neurologic complications of human immunodeficiency virus (HIV) infection remain common, despite effective antiretroviral treatment (ART). Neurologic manifestations may be due to opportunistic infection, immune reconstitution, or the virus itself, posing diagnostic challenges for the neurologist. Neurologists are also asked to comment on the use of immunomodulatory agents in these patients and to manage long-term complications, such as neurocognitive disorders and peripheral neuropathy or the associated comorbidities.

RECENT FINDINGS: HIV enters the central nervous system (CNS) soon after infection and can cause atrophy of the brain within 3 months of infection. As patients are living longer, comorbidities such as stroke associated with metabolic syndrome, hepatitis C, and drug abuse are important contributory factors to the neurologic and neuropsychiatric manifestations of HIV infection. Immune-mediated syndromes are increasingly being recognized in patients with HIV infection on antiretroviral therapy. This includes a subacute T-cell-mediated encephalitis called CNS-immune reconstitution inflammatory syndrome, fulminant multiple sclerosis-like lesions, and unmasking of underlying opportunistic infections with profound inflammatory reaction. Our understanding of the most appropriate antiretrovirals for treating or preventing CNS HIV replication continues to improve. Major efforts are being made to understand how the CNS reservoirs are established and maintained, and new approaches are being developed to develop a functional cure or eradicate the virus.

SUMMARY: This article reviews the neurologic complications caused by HIV infection, associated comorbidities, or antiretroviral drugs that are commonly encountered by neurologists.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
26633776
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.