Acute disseminated encephalomyelitis as manifestation of primary HIV infection

Narciso, Pasquale; Galgani, S.; Grosso, Bruno Del; Marco, Michele De; Santis, Antonella De; Balestra, Pietro; Ciapparoni, V.; Tozzi, Valerio

doi:10.1212/wnl.57.8.1493

Cited by 44 publications

(31 citation statements)

References 8 publications

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“…MND or dementia is most frequently associated with WM abnormalities in elderly people. Despite successful cART/HAART treatment in HIV-positive patients, they continue to have persistent untraceable viral load in the CNS, resulting in WM abnormalities and neuro-inflammation, and thus leading to mild to severe cognitive impairment and brain atrophy at older ages [240, 241]. Multiple studies show a significant interaction between age and HIV infection, as HIV-infected patients frequently exhibit a greater extent of structural deformation in cognitive regions of the brain with aging, including abnormalities in whole-brain WM hyperintensities and fronto-subcortical WM integrity, compared with age-matched HIV-negative individuals [242–245].…”

Section: Relationship Between Brain Structure Alterations and Aging Imentioning

confidence: 99%

An Overview of Human Immunodeficiency Virus Type 1-Associated Common Neurological Complications: Does Aging Pose a Challenge?

Nookala

Mitra

Chaudhari

et al. 2017

JAD

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With increasing survival of patients infected with human immunodeficiency virus type 1 (HIV-1), the manifestation of heterogeneous neurological complications is also increasing alarmingly in these patients. Currently, more than 30% of about 40 million HIV-1 infected people worldwide develop central nervous system (CNS)-associated dysfunction, including dementia, sensory, and motor neuropathy. Furthermore, the highly effective antiretroviral therapy has been shown to increase the prevalence of mild cognitive functions while reducing other HIV-1-associated neurological complications. On the contrary, the presence of neurological disorder frequently affects the outcome of conventional HIV-1 therapy. Although, both the children and adults suffer from the post-HIV treatment-associated cognitive impairment, adults, especially depending on the age of disease onset, are more prone to CNS dysfunction. Thus, addressing neurological complications in an HIV-1-infected patient is a delicate balance of several factors and requires characterization of the molecular signature of associated CNS disorders involving intricate cross-talk with HIV-1-derived neurotoxins and other cellular factors. In this review, we summarize some of the current data supporting both the direct and indirect mechanisms, including neuro-inflammation and genome instability in association with aging, leading to CNS dysfunction after HIV-1 infection, and discuss the potential strategies addressing the treatment or prevention of HIV-1-mediated neurotoxicity.

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Section: Relationship Between Brain Structure Alterations and Aging Imentioning

confidence: 99%

An Overview of Human Immunodeficiency Virus Type 1-Associated Common Neurological Complications: Does Aging Pose a Challenge?

Nookala

Mitra

Chaudhari

et al. 2017

JAD

View full text Add to dashboard Cite

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“…In the United States, the incidence of PIEM was significantly decreased following the introduction of widespread vaccination; however, in developing countries and even in some developed countries, because of incomplete vaccine coverage of the population, the disease remains poorly controlled [4][5][6]. Other recognized infectious precipitants for PIEM include other viral pathogens such as Epstein-Barr virus [7], herpes simplex virus [8], human herpes virus-6 [9], HIV [10,11], mumps virus [12], coxackie B virus [13], influenza virus [14], and cytomegalovirus [15]. Post-infectious encephalomyelitis has also been described in association with bacterial pathogens, including infections with Mycoplasma pneumonia [16,17], Legionella cincinnatiensis [18], and other atypical pneumonic infections.…”

Section: Epidemiologymentioning

confidence: 99%

Post-infectious encephalomyelitis

Mihai

Jubelt

2005

Curr Neurol Neurosci Rep

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The term post-infectious encephalomyelitis (PIEM) is frequently used interchangeably with acute disseminated encephalomyelitis (ADEM), although technically PIEM occurs after a known infection whereas with ADEM there is no antecedent infection. PIEM represents one of the primary demyelinating disorders of the central nervous system, along with multiple sclerosis and Devic's disease. There is no specific diagnostic test for any of these conditions and at onset it may be difficult to differentiate between ADEM and the first attack of multiple sclerosis. However, there are clinical and magnetic resonance imaging features that allow differentiation between PIEM/ADEM and a relapsing disease such as multiple sclerosis. Some patients improve spontaneously; most improve with methylprednisolone. If that fails, plasma exchange or intravenous immunoglobulin may be effective.

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“…Numerous viruses and vaccines have been implicated in case reports or small series, and some recent associations include HIV [6,7], human T-cell leukemia virus/lymphoma virus (HTLV)-1 [8], hepatitis C virus [9], Pontiac fever [10], Chlamydia pneumoniae [11], Legionella pneumophila [12], and hog vaccine [13]. Post-measles ADEM occurs at a rate of about one per 1000 infections and was historically associated with high rates of mortality (up to 25%) and permanent neurologic injury in survivors (25% to 40%).…”

Section: Infectious Agent Associationsmentioning

confidence: 99%

Postinfectious encephalomyelitis

Wingerchuk

2003

Curr Neurol Neurosci Rep

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Postinfectious forms of encephalomyelitis, also termed acute disseminated encephalomyelitis (ADEM), form one of several categories of inflammatory demyelinating disorders of the central nervous system (CNS). Recent large, retrospective case series have refined our understanding of the clinical, laboratory, and neuroimaging characteristics of ADEM. The differences between childhood and adult ADEM, risks of development of multiple sclerosis, and the contributions of recent studies to refining the nosology of CNS demyelinating syndromes are discussed.

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Acute disseminated encephalomyelitis as manifestation of primary HIV infection

Cited by 44 publications

References 8 publications

An Overview of Human Immunodeficiency Virus Type 1-Associated Common Neurological Complications: Does Aging Pose a Challenge?

An Overview of Human Immunodeficiency Virus Type 1-Associated Common Neurological Complications: Does Aging Pose a Challenge?

Post-infectious encephalomyelitis

Postinfectious encephalomyelitis

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