title: Clinical aspects of the AIDS dementia complex in relation to histopathological and immunohistochemical variables.
abstract: To correlate cerebral histopathological and immunohistochemical changes in the neuroclinical features of the AIDS dementia complex (ADC), autopsy results of 28 ADC patients were related, in a retrospective analysis, to scores on a standardised neurological examination performed at neurologic onset. From a histopathological point of view, the cases were classified as follows: 9 cases of HIV leucoencephalopathy (HIVL; diffuse myelin damage and rare microglial nodules), 7 cases of HIV encephalitis (HIVE; several microglial nodules and no myelin damage) and 12 cases of mixed HIVL and HIVE (HIVL-E). The groups differed significantly with respect to symptoms and CD4 count at neurologic onset, survival and neurological impairment. Immunohistochemically, the interstitial component (p24-positive cells scattered singly within the white matter) was significantly more prevalent in HIVL, and the micronodular component (p24-positive cells confined within microglial nodules) in HIVE. Neurological damage was worse in cases with a high prevalence of interstitial component or a low prevalence of micronodular component. HIVE, HIVL and HIVL-E are distinct clinical forms of ADC. Neurological impairment is related to white matter damage.
authors.affiliation: I Department of Neurology, L. Sacco Hospital, Milan, Italy. neurodept@mailserver.unimi.it
authors.forename: M P
authors.initials: MP
authors.lastname: Grassi
authors.forename: F
authors.initials: F
authors.lastname: Clerici
authors.forename: L
authors.initials: L
authors.lastname: Vago
authors.forename: C
authors.initials: C
authors.lastname: Perin
authors.forename: M
authors.initials: M
authors.lastname: Borella
authors.forename: M
authors.initials: M
authors.lastname: Nebuloni
authors.forename: M
authors.initials: M
authors.lastname: Moroni
authors.forename: A
authors.initials: A
authors.lastname: Mangoni
mesh_terms: D015526:AIDS Dementia Complex / Q000473:pathology* / Q000503:physiopathology; D000328:Adult; D001344:Autopsy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D012189:Retrospective Studies