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The Neurological Spectrum of HIV Infection

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CNS Infections

Abstract

Neurological manifestations are frequent in human immunodeficiency virus (HIV)-infected patients and represent a great diagnostic and therapeutic challenge. They may be caused by many different mechanisms: the HIV, opportunistic infections or tumors, autoimmunity, and complications of systemic diseases or drugs, including the antiretrovirals. Patients may suffer several simultaneous neurological diseases, and the HIV and some opportunistic infections may affect simultaneously various levels in the nervous system. Highly active antiretroviral therapy (HAART) has produced a decline in opportunistic diseases and neurological disorders associated with severe immune depression. However, the prolonged survival of patients has increased morbidity due to chronic disorders, such as cerebrovascular disease and HIV-associated neurocognitive disorders. The central nervous system constitutes a reservoir for HIV replication in patients with controlled systemic disease. HAART itself is related to new emerging neurological problems: the specific neurotoxicity of the drugs and the appearance of neurological immune reconstitution inflammatory syndromes.

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References

  1. Brew BJ. Medical management of AIDS patients. Central and peripheral nervous system abnormalities. Med Clin North Am. 1992;76:63–81.

    CAS  PubMed  Google Scholar 

  2. Gray F, Gherardi R, Scaravilli F. The neuropathology of the acquired immune deficiency syndrome (AIDS). A review. Brain. 1988;111(Pt 2):245–66.

    PubMed  Google Scholar 

  3. Tan IK, Smith BR, von Geldern G, Mateen FJ, McArthur JC. HIV-associated opportunistic infections of the CNS. Lancet Neurol. 2012;11:605–17.

    PubMed  Google Scholar 

  4. Maschke M, Kastrup O, Esser S, Ross B, Hengge U, Hufnagel A. Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART). J Neurol Neurosurg Psychiatry. 2000;69:376–80.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Sacktor N, Lyles RH, Skolasky MA, Kleeberger MAS, Selnes OA, Miller EN, et al. HIV-associated neurologic disease incidence changes: Multicenter AIDS Cohort Study, 1990-1998. Neurology. 2001;56:257–60.

    CAS  PubMed  Google Scholar 

  6. Valcour V, Chalermchai T, Sailasuta N, Marovich M, Lerdlum S, Suttichom D, et al. Central nervous system viral invasion and inflammation during acute HIV infection. J Infect Dis. 2012;206:275–82.

    Google Scholar 

  7. Peluso MJ, Meyerhoff DJ, Price RW, Peterson J, Lee E, Young AC, et al. Cerebrospinal fluid and neuroimaging biomarker abnormalities suggest early neurological injury in a subset of individuals during primary HIV infection. J Infect Dis. 2013;207:1703–12.

    Google Scholar 

  8. Wiley CA, Achim C. Human immunodeficiency virus encephalitis and dementia. Ann Neurol. 1995;38:559–60.

    CAS  PubMed  Google Scholar 

  9. Navia BA, Jordan BD, Price RW. The AIDS-dementia complex: I. Clinical features. Ann Neurol. 1986;19:517–24.

    CAS  PubMed  Google Scholar 

  10. Janssen RS. Epidemiology and neuroepidemiology of human immunodeficiency virus infection. In: Berger JR, Levy RM, editors. AIDS and the nervous system. Philadelphia: Lippincott-Raven; 1997. p. 13–37.

    Google Scholar 

  11. Maruff P, Currie J, Malone V, McArthur-Jacson C, Mulhall B, Benson E. Neuropsychological characterization of the AIDS dementia complex and rationalization of a test battery. Arch Neurol. 1994;51:689–95.

    CAS  PubMed  Google Scholar 

  12. Sacktor NC, Wong M, Nakasujja N, Skolasky RL, Selnes OA, Musisi S, et al. The International HIV Dementia Scale: a new rapid screening test for HIV dementia. AIDS. 2005;19:1367–74.

    Google Scholar 

  13. Cinque P, Vago L, Ceresa D, Mainini F, Terreni MR, Vagani A, et al. Cerebrospinal fluid HIV-1 RNA levels: correlation with HIV encephalitis. AIDS. 1998;12:389–94.

    CAS  PubMed  Google Scholar 

  14. Valcour VG, Shiramizu BT, Sithinamsuwan P, Nidhinandana S, Ratto-Kim S, Ananworanich J, et al. HIV DNA and cognition in a Thai longitudinal HAART initiation cohort The SEARCH 001 Cohort Study. Neurology. 2009;72:992–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, et al. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007;69:1789–99.

    CAS  PubMed  Google Scholar 

  16. Gisslén M, Price RW, Nilsson S. The definition of HIV-associated neurocognitive disorders: are we overestimating the real prevalence? BMC Infect Dis. 2011;11:356.

    PubMed Central  PubMed  Google Scholar 

  17. Cohen RA, Boland R, Paul R, Tashima KT, Schoenbaum EE, Celentano DD, et al. Neurocognitive performance enhanced by highly active antiretroviral therapy in HIV-infected women. AIDS. 2001;15:341–5.

    CAS  PubMed  Google Scholar 

  18. Cysique LA, Vaida F, Letendre S, Gibson S, Cherner M, Woods SP, et al. Dynamics of cognitive change in impaired HIV-positive patients initiating antiretroviral therapy. Neurology. 2009;73:342–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  19. Fessel WJ. Impaired neurocognition in HIV-infected patients: antecedents and treatment. AIDS. 2009;23:1731–3.

    PubMed  Google Scholar 

  20. Tozzi V, Balestra P, Bellagamba R, Corpolongo A, Salvatori MF, Visco-Comandini U, et al. Persistence of neuropsychologic deficits despite long-term highly active antiretroviral therapy in patients with HIV-related neurocognitive impairment: prevalence and risk factors. J Acquir Immune Defic Syndr. 2007;45:174–82.

    PubMed  Google Scholar 

  21. Heaton RK, Clifford DB, Franklin D, Woods S, Ake C, Vaida F, et al. HIV associated neurocognitive disorders (HAND) persist in the era of potent antiretroviral therapy: The CHARTER Study. Neurology. 2010;75:2087–96.

    CAS  PubMed Central  PubMed  Google Scholar 

  22. Simioni S, Cavassini M, Annoni JM, Rimbault Abraham A, Bourquin I, Schiffer V, et al. Cognitive dysfunction in HIV patients despite long-standing suppression of viremia. AIDS. 2010;24:1243–50.

    PubMed  Google Scholar 

  23. McCutchan JA, Marquie-Beck J, FitzSimons JA, Letendre SL, Ellis RJ, Heaton RK, et al. Role of obesity, metabolic variables, and diabetes in HIV-associated neurocognitive disorder. Neurology. 2012;78:485–92.

    Google Scholar 

  24. Wright EJ, Grund B, Robertson K, Brew BJ, Roediger M, Bain MP, et al. Cardiovascular risk factors associated with lower baseline cognitive performance in HIV-positive persons. Neurology. 2010;75:864–73.

    CAS  PubMed Central  PubMed  Google Scholar 

  25. Gannon P, Khan MZ, Kolson DL. Current understanding of HIV-associated neurocognitive disorders pathogenesis. Curr Opin Neurol. 2011;24:275–83.

    PubMed Central  PubMed  Google Scholar 

  26. Ellis RJ, Badiee J, Vaida F, Letendre S, Heaton RK, Clifford D, et al. CD4 nadir is a predictor of HIV neurocognitive impairment in the era of combination antiretroviral therapy. AIDS. 2011;25:1747–51.

    Google Scholar 

  27. Cohen RA, Harezlak J, Schifitto G, Hana G, Clark U, Gongvatana A, et al. Effects of nadir CD4 count and duration of human immunodeficiency virus infection on brain volumes in the highly active antiretroviral therapy era. J Neurovirol. 2010;16:25–32.

    CAS  PubMed Central  PubMed  Google Scholar 

  28. Shiramizu B, Ananworanich J, Chalermchai T, Siangphoe U, Troelstrup D, Shikuma C, et al. Failure to clear intra-monocyte HIV infection linked to persistent neuropsychological testing impairment after first-line combined antiretroviral therapy. J Neurovirol. 2012;18:69–73.

    CAS  PubMed Central  PubMed  Google Scholar 

  29. Harezlak J, Buchthal S, Taylor M, Schifitto G, Zhong J, Daar E, et al. Persistence of HIV-associated cognitive impairment, inflammation, and neuronal injury in era of highly active antiretroviral treatment. AIDS. 2011;25:625–33.

    CAS  PubMed  Google Scholar 

  30. Peluso MJ, Ferrett F, Peterson J, Lee E, Fuchs D, Boschini A, et al. Cerebrospinal fluid HIV escape associated with progressive neurologic dysfunction in patients on antiretroviral therapy with well controlled plasma viral load. AIDS. 2012;26:1765–74.

    CAS  PubMed  Google Scholar 

  31. Del Palacio Tamarit M, Quereda C, González-Rozas M, Corral I, Casado JL. HIV type 1 viral encephalitis after development of viral resistance to plasma suppressive antiretroviral therapy. AIDS Res Hum Retroviruses. 2012;28:83–6.

    Google Scholar 

  32. Soulie C, Fourati S, Lambert-Niclot S, Tubiana R, Canestri A, Girard PM, et al. HIV genetic diversity between plasma and cerebrospinal fluid in patients with HIV encephalitis. AIDS. 2010;24:2412–4.

    PubMed  Google Scholar 

  33. Letendre S, Marquie-Beck J, Capparelli E, Best B, Clifford D, Collier AC, et al. Validation of the CNS penetration effectiveness rank for quantifying antiretroviral penetration into the central nervous system. Arch Neurol. 2008;65:65–70.

    PubMed Central  PubMed  Google Scholar 

  34. Marra CM, Zhao Y, Clifford DB, Letendre S, Evans S, Henry K, et al. Impact of combination antiretroviral therapy on cerebrospinal fluid HIV RNA and neurocognitive performance. AIDS. 2009;23:1359–66.

    PubMed Central  PubMed  Google Scholar 

  35. Smurzynski M, Wu K, Letendre S, Robertson K, Bosch RJ, Clifford DB, et al. Effects of central nervous system antiretroviral penetration on cognitive functioning in the ALLRT cohort. AIDS. 2011;25:357–65.

    PubMed Central  PubMed  Google Scholar 

  36. Robertson K, Jiang H, Kumwenda J, Supparatpinyo K, Evans S, Campbell TB, et al. Improved neuropsychological and neurological functioning across three antiretroviral regimens in diverse resource-limited settings: AIDS Clinical Trials Group study a5199, the International Neurological Study. Clin Infect Dis. 2012;55:868–76.

    CAS  PubMed Central  PubMed  Google Scholar 

  37. Dahl V, Lee E, Peterson J, Spudich SS, Leppla I, Sinclair E. Fuchs, et al. Raltegravir treatment intensification does not alter cerebrospinal fluid VIH-1 infection or immunoactivation on suppressive therapy. J Infect Dis. 2011;204:1036–45.

    Google Scholar 

  38. Cysique LA, Waters EK, Brew BJ. Central nervous system antiretroviral efficacy in HIV infection: a qualitative and quantitative review and implications for future research. BMC Neurol. 2011;11:148.

    PubMed Central  PubMed  Google Scholar 

  39. Heaton RK, Franklin DR, Ellis RJ, McCutchan JA, Letendre SL, Leblanc S, et al. HIV-associated neurocognitive disorders before and during the era of combination antiretroviral therapy: differences in rates, nature, and predictors. J Neurovirol. 2011;17:3–16.

    CAS  PubMed Central  PubMed  Google Scholar 

  40. Clifford DB, Fagan AM, Holtzman DM, Morris JC, Teshome M, Shah AR, et al. CSF biomarkers of Alzheimer disease in HIV-associated neurologic disease. Neurology. 2009;73:1982–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  41. Chang L, Andres M, Sadino J, Jiang CS, Nakama H, Miller E, et al. Impact of apolipoprotein E ε4 and HIV on cognition and brain atrophy: Antagonistic pleiotropy and premature brain aging. Neuroimage. 2011;58:1017–27.

    CAS  PubMed Central  PubMed  Google Scholar 

  42. Soontornniyomkij W, Moore M, Gouaux B, Soontornniyomkij B, Tatro ET, Umlauf A, et al. Cerebral β-amyloid deposition predicts HIV-associated neurocognitive disorders in APOE e4 carriers. AIDS. 2012;26:2327–35.

    CAS  PubMed Central  PubMed  Google Scholar 

  43. Moore DJ, Arce M, Moseley S, McCutchan JA, Marquie-Beck J, Franklin DR, et al. Family history of dementia predicts worse neuropsychological functioning among HIV infected persons. J Neuropsychiatry Clin Neurosci. 2011;23:316–23.

    PubMed Central  PubMed  Google Scholar 

  44. Langford TD, Letendre SL, Marcote TD, Ellis RJ, McCutchan JA, Grant I, et al. Severe, demyelinating leukoencephalopathy in AIDS patients on antiretroviral therapy. AIDS. 2002;16:1019–29.

    PubMed Central  PubMed  Google Scholar 

  45. Newsome SD, Johnson E, Pardo C, McArthur JC, Nath A. Fulminant encephalopathy with basal ganglia hyperintensities in HIV-infected drug users. Neurology. 2011;76:787–94.

    CAS  PubMed Central  PubMed  Google Scholar 

  46. Antinori A, Ammassari A, De Luca A, Cingolani A, Murri R, Scoppettuolo G, et al. Diagnosis of AIDS-related focal brain lesions: a decision-making analysis based on clinical and neuroradiologic characteristics combined with polymerase chain reaction assays in CSF. Neurology. 1997;48:687–94.

    CAS  PubMed  Google Scholar 

  47. Kirk O, Reiss P, Uberti-Foppa C, Bickel M, Gerstoft J, Pradier C, et al. Safe interruption of maintenance therapy against previous infection with four common HIV-associated opportunistic pathogens during potent antiretroviral therapy. Ann Intern Med. 2002;137:239–50.

    PubMed  Google Scholar 

  48. Flinn IW, Ambinder RF. AIDS primary central nervous system lymphoma. Curr Op Neurol. 1996;8:373–6.

    CAS  Google Scholar 

  49. Diamond C, Taylor TH, Im I, Miradi M, Wallace M, Anton-Culver H. Highly active antiretroviral therapy is associated with prolonged survival among patients with AIDS-related primary central nervous system non-Hodgkin’s lymphoma. Curr HIV Res. 2006;4:375–8.

    CAS  PubMed  Google Scholar 

  50. Newell ME, Hoy JF, Cooper SG, DeGraaff B, Grulich AE, Bryant M, et al. Human immunodeficiency virus-related primary central nervous system lymphoma: factors influencing survival in 111 patients. Cancer. 2004;100:2627–36.

    PubMed  Google Scholar 

  51. Cinque P, Koralnik IJ, Gerevini S, Miro JM, Price RW. Progressive multifocal leukoencephalopathy in HIV-1 infection. Lancet Infect Dis. 2009;9:625–36.

    CAS  PubMed Central  PubMed  Google Scholar 

  52. Tan CS, Koralnik IJ. Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis. Lancet Neurol. 2010;9:425–37.

    CAS  PubMed Central  PubMed  Google Scholar 

  53. Wüthrich C, Cheng YM, Joseph JT, Kesari S, Beckwith C, Stopa E, et al. Frequent infection of cerebellar granule cell neurons by polyomavirus JC in progressive multifocal leukoencephalopathy. J Neuropathol Exp Neurol. 2009;68:15–25.

    PubMed Central  PubMed  Google Scholar 

  54. Lima MA, Drislane FW, Koralnik IJ. Seizures and their outcome in progressive multifocal leukoencephalopathy. Neurology. 2006;66:262–4.

    PubMed  Google Scholar 

  55. Sahraian MA, Radue EW, Eshaghi A, Besliu S, Minagar A. Progressive multifocal leukoencephalopathy: a review of the neuroimaging features and differential diagnosis. Eur J Neurol. 2012;19:1060–9.

    CAS  PubMed  Google Scholar 

  56. Cinque P, Scarpellini P, Vago L, Linde A, Lazzarin A. Diagnosis of central nervous system complications in HIV-infected patients: cerebrospinal fluid analysis by polymerase chain reaction. AIDS. 1997;11:1–17.

    CAS  PubMed  Google Scholar 

  57. Corral I, Quereda C, García-Villanueva M, Casado JL, Perez-Elias MJ, Navas E, et al. Focal monophasic demyelinating leukoencephalopathy in advanced HIV infection. Eur Neurol. 2004;52:36–41.

    PubMed  Google Scholar 

  58. De Luca A, Giancola ML, Ammassari A, Grisetti S, Paglia MG, Cingolani A, et al. The effect of potent antiretroviral therapy and JC virus load in cerebrospinal fluid on clinical outcome of patients with AIDS-associated progressive multifocal leukoencephalopathy. J Infect Dis. 2000;182:1077–83.

    PubMed  Google Scholar 

  59. Garcia De Viedma D, Diaz Infantes M, Miralles P, Berenguer J, Marin M, Muñoz L, et al. JC virus load in progressive multifocal leukoencephalopathy: analysis of the correlation between the viral burden in cerebrospinal fluid, patient survival, and the volume of neurological lesions. Clin Infect Dis. 2002;34:1568–75.

    PubMed  Google Scholar 

  60. Berger JR, Levy RM, Flomenhoft D, Dobbs M. Predictive factors for prolonged survival in acquired immunodeficiency syndrome-associated progressive multifocal leukoencephalopathy. Ann Neurol. 1998;44:341–9.

    CAS  PubMed  Google Scholar 

  61. Khanna N, Wolbers M, Mueller NJ, Garzoni C, Du Pasquier RA, Fux CA, et al. JC virus-specific immune responses in human immunodeficiency virus type 1 patients with progressive multifocal leukoencephalopathy. J Virol. 2009;83:4404–11.

    CAS  PubMed Central  PubMed  Google Scholar 

  62. Marzocchetti A, Tompkins T, Clifford DB, Gandhi RT, Kesari S, Berger JR, et al. Determinants of survival in progressive multifocal leukoencephalopathy. Neurology. 2009;73:1551–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  63. Miralles P, Berenguer J, Garcia de Viedma DV, Padilla B, Cosin J, Lopez-Bernaldo-de-Quiros JC, et al. Treatment of AIDS-associated progressive multifocal leukoencephalopathy with highly active antiretroviral therapy. AIDS. 1998;12:2467–72.

    CAS  PubMed  Google Scholar 

  64. Falcó V, Olmo M, Villar del Saz S, Guelar A, Santos JR, Gutiérrez M, et al. Influence of HAART on the clinical course of HIV-1–infected patients with progressive multifocal leukoencephalopathy: results of an observational multicenter study. J Acquir Immune Defic Syndr. 2008;49:26–31.

    PubMed  Google Scholar 

  65. Antiretroviral Therapy Cohort Collaboration. Variable impact on mortality of AIDS-defining events diagnosed during combination antiretroviral therapy: Not all AIDS-defining conditions are created equal. Clin Infect Dis. 2009;48:1138–51.

    Google Scholar 

  66. Hernández B, Dronda F, Moreno S. Treatment options for AIDS patients with progressive multifocal leukoencephalopathy. Expert Opin Pharmacother. 2009;10:403–16.

    PubMed  Google Scholar 

  67. Arribas JR, Storch GA, Clifford DB, Tselis AC. Cytomegalovirus encephalitis. Ann Intern Med. 1996;125:577–87.

    CAS  PubMed  Google Scholar 

  68. Grassi MP, Clerici F, Perin C, d’Arminio MA, Vago L, Borella M, et al. Microglial nodular encephalitis and ventriculoencephalitis due to cytomegalovirus infection in patients with AIDS: two distinct clinical patterns. Clin Infect Dis. 1998;27:504–8.

    CAS  PubMed  Google Scholar 

  69. Huang PP, McMeeking AA, Stempien MJ, Zagzag D. Cytomegalovirus disease presenting as a focal brain mass: report of two cases. Neurosurgery. 1997;40:1074–8.

    CAS  PubMed  Google Scholar 

  70. Quereda C, Corral I, Laguna F, Valencia ME, Tenorio A, Echeverría JM, et al. Diagnostic utility of a multiplex herpesvirus PCR assay performed with cerebrospinal fluid from human immunodeficiency virus-infected patients with neurological disorders. J Clin Microbiol. 2000;38:3061–7.

    CAS  PubMed Central  PubMed  Google Scholar 

  71. Anduze-Faris BM, Fillet AM, Gozlan J, Lancar R, Boukli N, Gasnault J, et al. Induction and maintenance therapy of cytomegalovirus central nervous system infection in HIV-infected patients. AIDS. 2000;14:517–24.

    CAS  PubMed  Google Scholar 

  72. Tan SV, Guiloff RJ, Scaravilli F, Klapper PE, Cleator GM, Gazzard BG. Herpes simplex type 1 encephalitis in acquired immunodeficiency syndrome. Ann Neurol. 1993;34:619–22.

    CAS  PubMed  Google Scholar 

  73. Cinque P, Vago L, Marenzi R, Guidici T, Weber R, Corradini D, et al. Herpes simplex virus infections of the central nervous system in human immunodeficiency virus-infected patients: clinical management by polymerase chain reaction assay of cerebrospinal fluid. Clin Infect Dis. 1998;27:303–9.

    CAS  PubMed  Google Scholar 

  74. Glesby MJ, Moore RD, Chaisson RE. Clinical spectrum of herpes zoster in adults infected with human immunodeficiency virus. Clin Infect Dis. 1995;21:370–5.

    CAS  PubMed  Google Scholar 

  75. Corral I, Quereda C, Antela A, Pintado V, Casado JL, Martín-Dávila P, et al. Neurological complications of varicella-zoster virus in human immunodeficiency virus-infected patients: changes in prevalence and diagnostic utility of polymerase chain reaction in cerebrospinal fluid. J Neurovirol. 2003;9:129–35.

    CAS  PubMed  Google Scholar 

  76. Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol. 2009;8:731–40.

    PubMed Central  PubMed  Google Scholar 

  77. Pinto AN. AIDS and cerebrovascular disease. Stroke. 1996;27:538–43.

    CAS  PubMed  Google Scholar 

  78. Ortiz G, Koch S, Gomano JG, Forteza AM, Rabinstein AA. Mechanisms of stroke in HIV-infected patients. Neurology. 2007;68:1257–61.

    CAS  PubMed  Google Scholar 

  79. Tipping B, de Villiers L, Wainwright H, Candy S, Bryer A. Stroke in patients with human immunodeficiency virus infection. J Neurol Neurosurg Psychiatry. 2007;78:1320–4.

    PubMed Central  PubMed  Google Scholar 

  80. The Writing Committee of the D:A:D: Study Group. Cardio- and cerebrovascular events in HIV-infected persons. AIDS. 2004;18:1811–7.

    Google Scholar 

  81. Corral I, Quereda C, Moreno A, Pérez-Elías MJ, Dronda F, Casado JL, et al. Cerebrovascular ischemic events in HIV-1-infected patients receiving highly active antiretroviral therapy: incidence and risk factors. Cerebrovasc Dis. 2009;27:559–63.

    PubMed  Google Scholar 

  82. Ovbiagele B, Nath A. Increasing incidence of ischemic stroke in patients with HIV infection. Neurology. 2011;76:444–50.

    PubMed Central  PubMed  Google Scholar 

  83. Domingo P, Suarez-Lozano I, Torres F, Pomar V, Ribera E, Galindo MJ, et al. Bacterial meningitis in HIV-1-infected patients in the era of highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2009;51:582–7.

    PubMed  Google Scholar 

  84. Casado JL, Quereda C, Oliva J, Navas E, Moreno A, Pintado V, et al. Candidal meningitis in HIV-infected patients: Analysis of 14 cases. Clin Infect Dis. 1997;25:673–6.

    CAS  PubMed  Google Scholar 

  85. Berenguer J, Moreno S, Laguna F, Vicente T, Adrados M, Ortega A, et al. Tuberculous meningitis in patients infected with the human immunodeficiency virus. N Engl J Med. 1992;326:668–72.

    CAS  PubMed  Google Scholar 

  86. Corral I, Quereda C, Navas E, Martín-Dávila P, Pérez-Elías MJ, Casado JL, et al. Adenosine deaminase activity in cerebrospinal fluid of HIV-infected patients: limited value for diagnosis of tuberculous meningitis. Eur J Clin Microbiol Infect Dis. 2004;23:471–6.

    CAS  PubMed  Google Scholar 

  87. Sánchez-Portocarrrero J, Pérez-Cecilia E, Jiménez-Escrig A, Martín-Rabadán P, Roca V, Ruíz-Yagüe M, et al. Tuberculous meningitis. Clinical characteristics and comparison with cryptococcal meningitis in patients with human immunodeficiency virus infection. Arch Neurol. 1996;53:671–6.

    Google Scholar 

  88. Del Pan GL, Glass JD, McArthur JC. Clinicopathologic correlations of HIV-1 associated vacuolar myelopathy. An autopsy-based case control study. Neurology. 1994;44:2159–64.

    Google Scholar 

  89. Beilke MA, Japa S, Moeller-Hadi C, Martin-Schild S. Tropical spastic paraparesis/human T leukemia virus type 1-associated myelopathy in HIV type 1-coinfected patients. Clin Infect Dis. 2005;41:57–63.

    Google Scholar 

  90. Gilden DH, Beinlich BR, Rubinstein EM, Stommel E, Swenson R, Rubinstein D, et al. Varicella-zoster virus myelitis: An expanding spectrum. Neurology. 1994;44:1818–23.

    CAS  PubMed  Google Scholar 

  91. Schiffito G, McDermott M, McArthur J. Incidence and risk factors for HIV-associated distal sensory polyneuropathy. Neurology. 2002;58:1764–8.

    Google Scholar 

  92. Evans SR, Ellis RJ, Chen H, Yeh T, Lee AJ, Schifitto G, et al. Peripheral neuropathy in HIV: prevalence and risk factors. AIDS. 2011;25:919–28.

    Google Scholar 

  93. Centne CM, Bateman KJ, Heckmann JM. Manifestations of HIV Infection in the peripheral nervous system. Lancet Neurol. 2013;12:295–309.

    Google Scholar 

  94. Cornblath DR, McArthur JC, Kennedy PGE, Witte AS, Griffin JW. Inflammatory demyelinating peripheral neuropathies associated with human T-cell lymphotropic virus type III infection. Ann Neurol. 1987;21:32–40.

    CAS  PubMed  Google Scholar 

  95. So YT, Olney RK. Acute lumbosacral polyradiculopathy in acquired immunodeficiency syndrome: experience in 23 patients. Ann Neurol. 1994;35:53–8.

    CAS  PubMed  Google Scholar 

  96. Corral I, Quereda C, Casado JL, Cobo J, Navas E, Pérez-Elías MJ, et al. Acute polyradiculopathies in HIV-infected patients. J Neurol. 1997;244:499–504.

    CAS  PubMed  Google Scholar 

  97. Cohen BA, McArthur JC, Grohman S, Patterson B, Glass JD. Neurologic prognosis of cytomegalovirus polyradiculomyelopathy in AIDS. Neurology. 1993;43:493–9.

    CAS  PubMed  Google Scholar 

  98. Roullet E, Assuerus V, Gozlan J, Ropert A, Saïd G, Baudrimont M, et al. Cytomegalovirus multifocal neuropathy in AIDS: Analysis of 15 consecutive cases. Neurology. 1994;44:2174–82.

    CAS  PubMed  Google Scholar 

  99. Simpson DM, Bender AN. HIV associated myopathy: Analysis of 11 patients. Ann Neurol. 1988;24:79–84.

    CAS  PubMed  Google Scholar 

  100. Mhiri C, Baudrimont M, Bonne G, Geny C, Degoul F, Marsac C, et al. Zidovudine myopathy: a distinctive disorder associated with mitochondrial dysfunction. Ann Neurol. 1991;29:606–14.

    CAS  PubMed  Google Scholar 

  101. Zetola NM, Klausner JD. Syphilis and HIV infection: An update. Clin Infect Dis. 2007;44:1222–8.

    PubMed  Google Scholar 

  102. Johnson T, Nath A. Immune reconstitution inflammatory syndrome and the central nervous system. Curr Op Neurol. 2011;24:284–90.

    CAS  Google Scholar 

  103. McCombe JA, Auer RN, Maingat FG, Houston S, Gill MJ, Power C. Neurologic immune reconstitution inflammatory syndrome in HIV/AIDS: outcome and epidemiology. Neurology. 2009;72:835–41.

    CAS  PubMed  Google Scholar 

  104. Pepper DJ, Marais S, Maartens G, Rebe K, Morroni C, Rangaka MX, et al. Neurologic manifestations of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome: a case series. Clin Infect Dis. 2009;48:e96–107.

    PubMed  Google Scholar 

  105. Bicanic T, Meintjes G, Rebe K, Williams A, Loyse A, Wood R, et al. Immune reconstitution inflammatory syndrome in HIV-associated cryptococcal meningitis: a prospective study. J Acquir Immune Defic Syndr. 2009;51:130–4.

    CAS  PubMed  Google Scholar 

  106. Bisson GP, Molefi M, Bellamy S, Thakur R, Steenhoff A, Tamuhla N, et al. Early versus delayed antiretroviral therapy and cerebrospinal fluid fungal clearance in adults with HIV and cryptococcal meningitis. Clin Infect Dis. 2013;56:1165–73.

    Google Scholar 

  107. Tan K, Roda R, Ostrow L, McArthur J, Nath A. PML-IRIS in patients with HIV infection. Clinical manifestations and treatment with steroids. Neurology. 2009;72:1458–64.

    CAS  PubMed Central  PubMed  Google Scholar 

  108. Safdar A, Rubocki RJ, Horvath JA, Narayan KK, Waldron RL. Fatal immune restoration disease in human immunodeficiency virus type 1-infected patients with progressive multifocal leukoencephalopathy: impact of antiretroviral therapy-associated immune reconstitution. Clin Infect Dis. 2002;35:1250–7.

    PubMed  Google Scholar 

  109. Martinez JV, Mazziotti JV, Efron ED, Bonardo P, Jordan R, Sevlever G, et al. Immune reconstitution inflammatory syndrome associated with PML in AIDS: a treatable disorder. Neurology. 2006;67:1692–4.

    CAS  PubMed  Google Scholar 

  110. Di Giambenedetto S, Vago G, Pompucci A, Scoppettuolo G, Cingolani A, Marzocchetti A, et al. Fatal inflammatory AIDS-associated PML with high CD4 counts on HAART: a new clinical entity? Neurology. 2004;63:2452–3.

    Google Scholar 

  111. Domingo P, Torres OH, Ris J, Vázquez G. Herpes zoster as an immune reconstitution disease after initiation of combination antiretroviral therapy in patients with human immunodeficiency virus type-1 infection. Am J Med. 2001;110:605–9.

    CAS  PubMed  Google Scholar 

  112. González-Valcárcel J, Corral I, Quereda C, Alonso-Cánovas A, Aparicio Hernandez M, de Felipe Mimbrera A, et al. Primary cerebral lymphomatoid granulomatosis as an immune reconstitution inflammatory syndrome in AIDS. J Neurol. 2010;257:2106–8.

    PubMed  Google Scholar 

  113. Lescure FX, Moulignier A, Savatovsky J, Amiel C, Carcelain G, Molina JM, et al. CD8 encephalitis in HIV-infected patients receiving cART: a treatable entity. Clin Infect Dis. 2013;57:101–8.

    CAS  PubMed  Google Scholar 

  114. Gray F, Lescure FX, Adle-Biassette H, Polivka M, Gallien S, Pialoux G, et al. Encephalitis with infiltration by CD8+ lymphocytes in HIV patients receiving combination antiretroviral treatment. Brain Pathol. 2013;23:525–33.

    Google Scholar 

  115. Simpson D, Estanislao L, Evans S, McArthur J, Markus K, Truffa M, et al. HIV-associated neuromuscular weakness syndrome. AIDS. 2004;18:1403–12.

    Google Scholar 

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Correspondence to Iñigo Corral MD, PhD .

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Corral, I., Quereda, C. (2014). The Neurological Spectrum of HIV Infection. In: García-Moncó, J. (eds) CNS Infections. Springer, London. https://doi.org/10.1007/978-1-4471-6401-2_15

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