[HIV infection and the development of dementia]

Progressive dementia has been described in AIDS patients as the most significant neurologic complication, related to HIV-1 infection directly rather than to opportunistic infections. As the virus seems to enter brain early in the course of infection, incipient dementia or subclinical cognitive impairment have been assumed to occur in otherwise asymptomatic HIV-1 seropositive individuals. A review of relevant neuropsychological studies indicates that this suspicion receives no support in large well-controlled studies. The natural history of AIDS dementia is still not clearly delineated, but encephalopathy seems to develop only with or after systemic immunosuppression.