RT Journal Article
SR Electronic
T1 HIV, dementia and antiretroviral drugs: 30 years of an epidemic
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1126
OP 1137
DO 10.1136/jnnp-2012-304022
VO 84
IS 10
A1 Manji, Hadi
A1 Jäger, H R
A1 Winston, Alan
YR 2013
UL http://jnnp.bmj.com/content/84/10/1126.abstract
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.