[Neurological complications of HIV infection. Review: new diagnostic, therapeutic and prognostic aspects].
About one third of patients with HIV infection show neurological complications with considerable morbidity and high mortality. This is an actualized review of the most important neurological manifestations resulting from primary HIV infection, from secondary opportunistic infections, or as complications of antiretroviral therapy. The primary neurological manifestations, including HIV-associated dementia complex, myelopathies, peripheral neuropathies and myopathies, the more common opportunistic infections, primary central nervous system lymphoma and cerebrovascular diseases, are discussed in the light of new evidence in diagnosis, therapy and prognosis. Cognitive and psychiatric symptoms, visual changes, headache, seizures, dizziness, involuntary movements, gait disturbances, cranial neuropathies and focal deficits are the common neurological symptoms in HIV infection which are described under the aspect of differential diagnosis. It is important to bear in mind that nearly all information available to date on this subject concerns HIV patients in the period before combination therapies (including protease inhibitors). The introduction of highly active antiretroviral therapy (HAART) with protease inhibitors in 1995, and non-nucleoside reverse transcriptase inhibitors, have opened up new therapeutic modalities with a new emphasis on earlier detection and treatment of neurological complications. The prognosis of different HIV-associated neurological diseases has considerably improved, as recently shown in the case, for example, of progressive multifocal leucoencephalopathy.
Radziwill
A J
AJ
Neurologische Universitätsklinik und Poliklinik, Kantonsspital Basel. aradziwill@uhbs.ch
Kappos
L
L
Battegay
M
M
Steck
A J
AJ
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000628:therapy*; D015658:HIV Infections / Q000150:complications* / Q000628:therapy; D006801:Humans; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011379:Prognosis