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Updated: Feb 7, 2026
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Ex Vivo Infection of Human Lymphoid Tissue and Female Genital Mucosa with Human Immunodeficiency Virus 1 and Histoculture
Published on: October 12, 2018
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Brain MRI Features of CSF Human Immunodeficiency Virus Escape
Jared Narvid1, Andrew Callen1, Jason Talbott1,2
1University of California at San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center, Department of Radiology and Biomedical Imaging, San Francisco, CA.
Summary
Central nervous system (CNS) HIV escape can present with neurological symptoms. MRI findings in neurosymptomatic escape show distinct white matter abnormalities and perivascular enhancement, aiding diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Central nervous system (CNS) HIV infection is common in untreated HIV.
- Combination antiretroviral therapy (ART) usually suppresses CNS HIV.
- CSF HIV escape, with higher HIV levels in cerebrospinal fluid than blood, can occur despite ART.
Purpose of the Study:
- To describe MRI findings in patients with neurosymptomatic escape.
- To identify imaging characteristics associated with neurosymptomatic escape.
Main Methods:
- Retrospective review of MRI findings in 6 patients with neurosymptomatic escape.
- Analysis of imaging characteristics and comparison with known HIV encephalitis patterns.
Main Results:
- MRI revealed patchy white matter signal abnormalities and perivascular enhancement.
- These findings were atypical for patients on ART and differed from untreated HIV encephalitis.
- Neurosymptomatic escape may involve a distinct CNS HIV subpopulation with robust immune responses.
Conclusions:
- Recognition of specific MRI findings, including white matter intensities and perivascular enhancement, is crucial.
- These imaging features, combined with clinical and CSF data, aid in diagnosing neurosymptomatic escape.
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