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Human immunodeficiency virus and the brain

J D Glass¹, R T Johnson

¹Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.

Annual Review of Neuroscience

|January 1, 1996

Summary

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Human immunodeficiency virus (HIV) affects the central nervous system, potentially causing neurological syndromes and HIV-associated dementia in AIDS patients. Pathogenesis involves neurotoxins, immune dysregulation, and specific HIV strains.

Area of Science:

Neuroscience
Infectious Diseases
Immunology

Background:

Human immunodeficiency virus (HIV) frequently impacts the central nervous system (CNS).
Neurological complications are common during the course of HIV infection.
HIV-associated dementia (HAD) is a specific neurocognitive disorder seen in some AIDS patients.

Purpose of the Study:

To review the effects of HIV on the CNS.
To focus on the pathogenesis of HIV-associated dementia.
To discuss factors contributing to HAD development.

Main Methods:

Review of existing literature on HIV CNS effects.
Analysis of proposed mechanisms for HIV-associated dementia.
Discussion of potential interactions between pathogenic factors.

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Main Results:

HIV infection leads to diverse neurological syndromes.
The precise reasons for HAD development in a subset of patients remain unclear.
Multiple factors are implicated in HAD pathogenesis.

Conclusions:

Neurotoxins from HIV and infected immune cells contribute to HAD.
Immunologic dysregulation of macrophages plays a role.
Specific HIV genetic strains may influence disease development.