title: HIV, dementia and antiretroviral drugs: 30 years of an epidemic.
abstract: Neurological complications due to the HIV itself became apparent early on in the course of the AIDS epidemic. The most feared were the cognitive and motor complications termed AIDS dementia complex or HIV-associated dementia. With the introduction of combination antiretroviral therapy, the incidence of HIV-associated dementia has been dramatically reduced. However, the prevalence of less severe forms of the disorder remains around 20%. There is controversy about whether some patients may continue with progressive cognitive decline despite adequate suppression of the HIV. The salient issues are those of cerebrospinal fluid (CSF) drug penetration, drug neurotoxicity and persistent immune activation and inflammation. This review will also discuss other newly encountered complications, including the compartmentalisation (or CSF escape) and immune reconstitution inflammatory syndromes.
authors: MRC Centre for Neuromuscular Diseases, The National Hospital for Neurology and Neurosurgery, London, USA. hadi.Manji@uclh.nhs.uk
authors: Hadi
authors: H
authors: Manji
authors: H R
authors: HR
authors: Jäger
authors: Alan
authors: A
authors: Winston
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001921:Brain / Q000187:drug effects / Q000473:pathology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004359:Drug Therapy, Combination; D058872:Epidemics; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D054019:Immune Reconstitution Inflammatory Syndrome / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D012307:Risk Factors; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS; CSF; Dementia; MRI; Neuropathology