PT  - JOURNAL ARTICLE
AU  - Manji, Hadi
AU  - Jäger, H R
AU  - Winston, Alan
TI  - HIV, dementia and antiretroviral drugs: 30 years of an epidemic
AID  - 10.1136/jnnp-2012-304022
DP  - 2013 Oct 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 1126--1137
VI  - 84
IP  - 10
4099  - http://jnnp.bmj.com/content/84/10/1126.short
4100  - http://jnnp.bmj.com/content/84/10/1126.full
SO  - J Neurol Neurosurg Psychiatry2013 Oct 01; 84
AB  - Neurological complications due to the HIV itself became apparent early on in the course of the AIDS epidemic. The most feared were the cognitive and motor complications termed AIDS dementia complex or HIV-associated dementia. With the introduction of combination antiretroviral therapy, the incidence of HIV-associated dementia has been dramatically reduced. However, the prevalence of less severe forms of the disorder remains around 20%. There is controversy about whether some patients may continue with progressive cognitive decline despite adequate suppression of the HIV. The salient issues are those of cerebrospinal fluid (CSF) drug penetration, drug neurotoxicity and persistent immune activation and inflammation. This review will also discuss other newly encountered complications, including the compartmentalisation (or CSF escape) and immune reconstitution inflammatory syndromes.