title: Neurologic diseases in HIV-infected patients.
abstract: Since the introduction of highly active antiretroviral therapy there has been an improvement in the quality of life for people with HIV infection. Despite the progress made, about 70% of HIV patients develop neurologic complications. These originate either in the central or the peripheral nervous system (Sacktor, 2002). These neurologic disorders are divided into primary and secondary disorders. The primary disorders result from the direct effects of the virus and include HIV-associated neurocognitive disorder (HAND), HIV-associated vacuolar myelopathy (VM), and distal symmetric polyneuropathy (DSP). Secondary disorders result from marked immunosuppression and include opportunistic infections and primary central nervous system lymphoma (PCNSL). A differential diagnosis which can be accomplished by detailed history, neurologic examination, and by having a good understanding of the role of HIV in various neurologic disorders will help physicians in approaching these problems. The focus of this chapter is to discuss neuropathogenesis of HIV, the various opportunistic infections, primary CNS lymphoma, neurosyphilis, CNS tuberculosis, HIV-associated peripheral neuropathies, HIV-associated neurocognitive disorder (HAND), and vacuolar myelopathy (VM). It also relies on the treatment recommendations and guidelines for the above mentioned neurologic disorders proposed by the US Centers for Disease Control and Prevention (CDC) and the Infectious Diseases Society of America.
authors.affiliation: Department of Medicine, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Bilgrami
authors.affiliation: Department of Medicine, Loyola University Medical Center, Maywood, IL, USA. Electronic address: pokeefe@lumc.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: O'Keefe
mesh_terms: D015526:AIDS Dementia Complex / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D017088:AIDS-Related Opportunistic Infections / Q000473:pathology / Q000628:therapy; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D009468:Neuromuscular Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy; D009494:Neurosyphilis / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D013118:Spinal Cord Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy; D020306:Tuberculosis, Central Nervous System / Q000150:complications / Q000453:epidemiology / Q000628:therapy
keywords: CMV encephalitis; HIV-associated neurocognitive disorder (HAND); Highly active antiretroviral therapy (HAART); Toxoplasma encephalitis; cryptococcal meningitis; neurosyphilis; primary central nervous system lymphoma (PCNSL); progressive multifocal leukoencephalopathy (PML); vacuolar myelopathy (VM)