HIV Infection of Human Nervous System Neurologic Manifestations, Diagnosis, and Treatment
Christian Cajavilca, Debra Davis, Oleg Y. Chernyshev, and Alireza Minagar
Human immunodeficiency virus (HIV) passes through the blood-brain barrier (BBB) and enters the central nervous system (CNS) at early stages of AIDS in recently seroconverted and yet clinically asymptomatic patients. HIV genetic material can be discovered and extracted from cerebrospinal fluid (CSF), brain, and spinal cord as well as peripheral nerves of AIDS patients. Depending on the severity of the HIV-induced immunosuppression, the clinical manifestations of neuroAIDS vary and entail dementia, myelopathy, opportunistic infections, polyneuropathy, stroke, and HIV-associated neurocognitive disorders (HAND) among other less common complications.
Various pathogenic mechanisms involved in development of neurologic complications of AIDS include direct HIV-induced neurotoxicity, opportunistic infections stemming from immunosuppression, profound abnormalities of the immune system, and impediments and complexities originating from reconstitution of the immune system.