Acute meningoencephalitis in chronic human immunodeficiency virus (HIV) infection: putative central nervous system escape of HIV replication.
We describe 3 patients with chronic human immunodeficiency virus (HIV) infection who presented with syndromes compatible with acute meningoencephalitis secondary to HIV; these syndromes were characterized by elevated cerebrospinal spinal fluid (CSF) HIV viral loads and T2-weighted signal abnormalities on magnetic resonance imaging of the brain. After the initiation of or a change in highly active antiretroviral therapy (HAART), each of the patients had significant and rapid improvement in neurologic symptoms and dramatic reductions in CSF HIV viral loads. Although further investigation is needed, these findings suggest that measurement of CSF HIV viral load and treatment with central nervous system-penetrating HAART should be considered for patients with acute neurologic complaints, chronic HIV infection, and no other identifiable cause of neurologic illness.
Wendel
Karen A
KA
Division of Infectious Diseases, Oklahoma University Health Science Center, Oklahoma City, OK 73104, USA. karen-wendel@ouhsc.edu
McArthur
Justin C
JC
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D002490:Central Nervous System / Q000821:virology*; D002908:Chronic Disease; D005260:Female; D006678:HIV / Q000187:drug effects / Q000502:physiology*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000209:etiology* / Q000821:virology; D008875:Middle Aged; D019562:Viral Load; D014779:Virus Replication
D019380:Anti-HIV Agents