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Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection
Abstract:
Subacute encephalitis, characterized by demyelination, gliosis of the gray and white matter, focal necrosis, microglial nodules, atypical oligodendrocyte nuclei, and multinucleation of cells, was present in 27 of 30 (90%) autopsied patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex. Subacute encephalitis was mainly distributed in the frontal (58%) and temporal (69%) lobes, basal ganglia (77%), amygdala (80%), and hippocampus (64%). Ten (37%) with moderate or severe subacute encephalitis were demented; 82% with mild subacute encephalitis had no recognized neurologic disorder. Human T-lymphotropic virus type III (HTLV-III) was isolated from neural tissue or CSF in 11 of 13 patients, 10 with subacute encephalitis, and 1 without CNS lesions. We conclude that subacute encephalitis is common in AIDS patients and is most likely caused by CNS infection with HTLV-III.
Insights
Subacute encephalitis is common in acquired immune deficiency syndrome (AIDS) patients, affecting 90%. This brain inflammation is linked to human T-lymphotropic virus type III (HTLV-III) central nervous system infection.
Area of Science:
- Neuropathology
- Infectious Diseases
- Neurovirology
Background:
- Subacute encephalitis is a neuropathological condition.
- Acquired immune deficiency syndrome (AIDS) is an advanced stage of human immunodeficiency virus (HIV) infection.
Purpose of the Study:
- To investigate the prevalence and characteristics of subacute encephalitis in patients with AIDS.
- To determine the association between subacute encephalitis and human T-lymphotropic virus type III (HTLV-III) in the central nervous system (CNS).
Main Methods:
- Autopsy examination of brain tissue from 30 patients with AIDS or AIDS-related complex.
- Histopathological analysis for signs of encephalitis, including demyelination and gliosis.
- Isolation of human T-lymphotropic virus type III (HTLV-III) from neural tissue and cerebrospinal fluid (CSF).
Main Results:
- Subacute encephalitis was observed in 90% of autopsied AIDS patients.
- Encephalitis predominantly affected the frontal and temporal lobes, basal ganglia, amygdala, and hippocampus.
- Human T-lymphotropic virus type III (HTLV-III) was isolated from 10 of 11 patients with subacute encephalitis.
Conclusions:
- Subacute encephalitis is a frequent finding in AIDS patients.
- Central nervous system (CNS) infection with human T-lymphotropic virus type III (HTLV-III) is the likely cause of subacute encephalitis in AIDS.