Reducing central nervous system complications associated with the human immunodeficiency virus
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According to recent epidemiological data, the worldwide prevalence of the human immunodeficiency virus (HIV) is now approaching 34 million, with two-thirds of sufferers residing in Sub-Saharan Africa, where new infection rates are also at their highest. HIV frequently involves the nervous system as a consequence of direct viral effects or complications relating to the immunodeficient state. However, although the CNS complications of HIV are well recognized, the relative frequency, mortality rates and risk factors in areas lacking ready access to combined antiretroviral therapy (cART) is poorly documented.
The first effective treatment for HIV (Zidovudine) was reported in 1987, and cART introduced widely in Western countries in 1996. In countries with ready access to these medications, the incidence of CNS involvement then significantly declined from 13/1,000 patient years to 1/1,000 in 2006/7. Since that time efforts have continued to be directed at reducing the incidence...