Immunopathogenesis of HIV encephalitis.
HIV infection leads to severe immunosuppression and in a sub-population of patients, encephalitis. Whether systemic immunosuppression is required for CNS infection is still unclear. However, latent infection of monocytes/macrophages is an important mechanism by which HIV escapes immune surveillance and enters the CNS. Unlike other viral encephalitides, HIV predominantly infects macrophages/microglia and not neurons and glia. These cells produce retroviral proteins and cytokines which may be neurotoxic. Despite significant MHC expression within the CNS, there is a limited infiltration of immune cells, possibly due to a defect in systemic immunity. Anti-retroviral therapy by decreasing viral replication and reversing immunosuppression, may arrest nervous system damage.
Achim
C L
CL
Department of Pathology, University of California San Diego, La Jolla 92093-0612.
Schrier
R D
RD
Wiley
C A
CA
D002465:Cell Movement; D002490:Central Nervous System / Q000276:immunology / Q000382:microbiology; D003588:Cytopathogenic Effect, Viral; D004660:Encephalitis / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D015658:HIV Infections / Q000276:immunology / Q000473:pathology*; D006801:Humans; D016867:Immunocompromised Host; D007577:JC Virus; D008264:Macrophages / Q000382:microbiology; D008582:Meningitis, Aseptic / Q000276:immunology / Q000382:microbiology; D009000:Monocytes / Q000382:microbiology; D030361:Papillomavirus Infections / Q000276:immunology; D011051:Poliomyelitis / Q000276:immunology; D014412:Tumor Virus Infections / Q000276:immunology