The Pathogenesis of HIV Infections of the Brain
Last summer, the World Health Organization estimated that over 13 million persons worldwide were infected with the human immunodeficiency virus (HIV) (Merson 1993). From prospective studies, it is reasonable to assume that the majority of these persons already have infection of the central nervous system; therefore, HIV is the most prevalent viral infection of the nervous system. It also can be assumed that during the next decade over 50% of these patients will develop disabling neurological diseases (dementia with HIV encephalopathy, paraparesis with vacuolar myelopathy, and disabling pain with predominantly sensory neuropathy); therefore, neurological complications of the acquired immunodeficiency syndrome (AIDS) will be among the commonest neurological diseases of the future.
KeywordsToxicity Lymphoma Attenuation Pneumonia Dementia
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- Centers for Disease Control (1981a) Kaposi’s sarcoma and pneumocystis pneumonia among homo-sexual men—New York City and California. Morb Mort Wkl Rep 30: 305–308Google Scholar
- Centers for Disease Control (1981 b) Pneumocystis pneumonia—Los Angeles. Morb Mort Wkl Rep 30: 250–252Google Scholar
- Griffin JW, Crawford TO, Tyor WR, Glass JD, Price DL, Cornblath DR, McArthur JC (1995) Sensory neuropathy in AIDS. I. Neuropathology. Brain (in press)Google Scholar
- Heyes MP, Brew BJ, Martin A, Price RW, Salazar AM, Sidtis JJ, Yergey JA, Mouradian MM, Sadler AE, Keilp J, Rubinow D, Markey SP (1991) Quinolinic acid in cerebrospinal fluid and serum in HIV-1 infection: relationship to clinical and neurologic status. Ann Neurol 29: 202–209PubMedCrossRefGoogle Scholar
- Ho DD, Rota TR, Schooley RT, Kaplan JC, Allan JD, Groopman JE, Resnick L, Felnsenstein D, Andrews CA, Hirsch MS (1985) Isolation of HTLV-III from cerebrospinal fluid and neural tissues of patients with neurologic syndromes related to the acquired immunodeficiency syndrome. N Engl J Med 313: 1493–1497PubMedCrossRefGoogle Scholar
- McArthur JC, Cohen BA, Seines OA, Kumar AJ, Cooper K, McArthur JH, Soucy G, Cornblath DC, Chmiel JS, Wang M-C, Starkey DL, Ginzburg H, Ostrow DG, Johnson RT, Phair JP, Polk BF (1989) Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1infected individuals: results from the multicenter AIDS cohort study. Ann Neurol 26: 601–611PubMedCrossRefGoogle Scholar
- Moses AV, Bloom FE, Pauza CD, Nelson JA (1993) Human immunodeficiency virus infection of human brain capillary endothelial cells occurs via a CD4/galactosylceramide-independent mechanism. Proc Natl Acad Sci USA 90: 1 0474–1 047 8Google Scholar
- Pizzo PA, Eddy J, Falloon J, Balis FM, Murphy RF, Moss H, Wolter P, Brouwers P, Jarosinski P, Rubin M, Broder S, Yarchoan R, Brunetti A, Maha M, Nusinoff-Lehrman S, Poplack DG (1988) Effect of continuous intravenous infusion of zidovudine ( AZT) in children with symptomatic HIV infection. N Engl J Med 319: 889–896PubMedCrossRefGoogle Scholar
- Resnick L, DiMarzo-Veronese F, Schüpbach J, Tourtellotte WW, Ho DD, Müller F, Shapshak P, Vogt M, Groopman JE, Markham PD, Gallo RC (1985) Intra-blood-brain-barrier synthesis of HTLV-III-specific IgG in patients with neurologic symptoms associated with AIDS or AIDS-related complex. N Engl J Med 313: 1498–1504PubMedCrossRefGoogle Scholar
- Saito Y, Sharer LR, Epstein LG, Michaels J, Mintz M, Louder M, Golding K, Cvetkovich TA, Blumberg BM (1994) Overexpression of nef as a marker for restricted HIV-1 infection of astrocytes in postmortem pediatric central nervous tissues Neurology 44: 474–481Google Scholar
- Seines OA, Miller E, McArthur JC, Gordon B, Munoz A, Sheridan K, Fox R, Saah AJ (1990) HIV-1 infection: no evidence of cognitive decline during the asymptomatic stages. Neurology 40: 204–208Google Scholar