HIV on your mind?

Literally. HIV on the mind. And all across the remainder of the neuroaxis.

In May, we posted an interview with Dr. Joseph Berger on BrainWaves where the complications of acute and chronic HIV on the central and peripheral nervous system were reviewed in detail.

In that interview, Dr. Berger (below) discusses his experience with the history of this relatively recently discovered pathogen. It’s quite an impressive story actually, and one that we did not get to focus too deeply on given the time allotted for an interview on neurologic complications of HIV. From his tour of duty in Miami, to his research in Kentucky, to Philadelphia, he has seen it all. One of the world’s foremost authorities on Dr. Berger can recite the rich history of the virus and the clumsiness with which we have attempted to manage it.

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Some of the complications of HIV in the nervous system may quickly follow inoculation, such as acute meningitis, whereas others reveal a more chronic decline in immunologic function. Directly toxic effect of HIV (and some of its treatments) may result in neuropathy or myopathy, a vasculopathy with greater risk of stroke, or affect the dorsal and lateral horns of the spinal cord, resulting in a progressive myelopathy. Opportunistic infections like progressive multifocal leukoencephalopathy are particularly challenging, especially with reconstitution of the immune system with antiretroviral therapy. The road to treatment is paved with a myriad of complications that can prove debilitating or life threatening. Check out this episode on HIV in the nervous system if you want to take in some of the details.

 

[Jim Siegler]


The content in this episode was vetted and approved by Joseph Berger.

REFERENCES

Ellis R, Langford D and Masliah E. HIV and antiretroviral therapy in the brain: neuronal injury and repair. Nat Rev Neurosci. 2007;8:33-44.

Boisse L, Gill MJ and Power C. HIV infection of the central nervous system: clinical features and neuropathogenesis. Neurol Clin. 2008;26:799-819, x.

Garg RK. HIV infection and seizures. Postgraduate medical journal. 1999;75:387-90.

Dore GJ, Law MG and Brew BJ. Prospective analysis of seizures occurring in human immunodeficiency virus type-1 infection. J NeuroAIDS. 1996;1:59-69.

Di Rocco A and Simpson DM. AIDS-associated vacuolar myelopathy. AIDS Patient Care STDS. 1998;12:457-61.

Murdoch DM, Venter WD, Van Rie A and Feldman C. Immune reconstitution inflammatory syndrome (IRIS): review of common infectious manifestations and treatment options. AIDS Res Ther. 2007;4:9.

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  1. June 24, 2016

    […] in poliomyelitis, enterovirus D68 associated flaccid paralysis, and west nile virus myelitis. HIV, in contrast, produces a myelopathy that is vacuolar on histopathology, and can […]

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