Pathology of neurologic disease in AIDS

The brain is a frequent target of damage in AIDS. In addition to abundant opportunistic infections, HIV itself can cause CNS destruction. Numerous important clinical questions await a basic understanding of the pathogenesis of HIV-associated nervous system destruction. Why does HIV, like many other retroviruses, attack the CNS? How does it get into the CNS, and once it is there, what controls viral replication? What is the mechanism(s) by which HIV mediates CNS damage, and how soon after infection is this process initiated? In the next few years, there will be a rapid convergence of multiple approaches to understanding the pathogenesis of HIV damage in the brain. What clinicians learn will not only aid those patients afflicted with AIDS, but very likely will provide insights into numerous other mysterious and potentially retrovirus-mediated brain diseases.