CD8+ encephalitis: a severe but treatable HIV-related acute encephalopathy.
Rapidly progressive encephalopathy in an HIV-positive patient presents a major diagnostic and management challenge. CD8+ encephalitis is a severe but treatable form of HIV-related acute encephalopathy, characterised by diffuse perivascular and intraparenchymal CD8+ lymphocytic infiltration. It can occur in patients who are apparently stable on antiretroviral treatment and probably results from viral escape into the central nervous system. Treatment, including high-dose corticosteroids, can give an excellent neurological outcome, even in people with severe encephalopathy and a very poor initial neurological status. We report a woman with CD8+ encephalitis, with a normal CD4 count and undetectable serum viral load, who made a good recovery despite the severity of her presentation.
National Hospital for Neurology and Neurosurgery, London, UK.
Angeliki
A
Zarkali
National Hospital for Neurology and Neurosurgery, London, UK.
Nikos
N
Gorgoraptis
Research Department of Infection and Population Health, University College London, London, UK.|Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
Robert
R
Miller
London North West Hospitals, London, UK.
Laurence
L
John
National Hospital for Neurology and Neurosurgery, London, UK.
Ashirwad
A
Merve
National Hospital for Neurology and Neurosurgery, London, UK.
Stefanie
S
Thust
National Hospital for Neurology and Neurosurgery, London, UK.|Neuroradiological Academic Unit, Department of Brain Repair & Rehabilitation, UCL Institute of Neurology, London, UK.
Rolf
R
Jager
National Hospital for Neurology and Neurosurgery, London, UK.|Institute of Neurology, University College London, London, UK.
Dimitri
D
Kullmann
National Hospital for Neurology and Neurosurgery, London, UK.|Institute of Neurology, University College London, London, UK.
Orlando
O
Swayne
D015526:AIDS Dementia Complex / Q000188:drug therapy* / Q000276:immunology* / Q000473:pathology; D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D044966:Anti-Retroviral Agents
CD8+ encephalitis; Confusion; HIV