International NeuroAIDS: prospects of HIV-1 associated neurological complications

Abstract

Neurological complications associated with HIV-1/AIDS are being recognized with a high frequency that parallels the increased number of AIDS cases. The early infiltration by HIV-1 into the nervous system can cause primary and/or secondary neurological complications. The most common neurocognitive disorder is AIDS Dementia Complex (ADC). In developing countries of Asia the three most opportunistic infections are tuberculosis (TB), cryptococcosis, and Pneumocystis carinii pneumonia. Therefore, it is expected that secondary neurological complications due to TB and cryptococcosis will be the most common cause of morbility and mortality in HIV-1/AIDS cases in China. Research of NeuroAIDS in China is necessary to understand the impact and the biology of HIV-1 in the nervous system. Future studies would include, the molecular epidemiology and the description of opportunistic infections associated to HIV-1; the neuropathological description of primary and secondary HIV-1 complications in different groups; the HIV-1 neurotropism and immune response studies for China's unique HIV-1 strains and recombinant forms derived from the nervous system, including experimental models such as the use of transgenic rats; and the study of potential resistant virus, primarily when the anti-retroviral therapy (ART) has not full access in the brain.

Toxoplasmosis in HIV/AIDS Patients - A Living Legacy

“…Primary CNS lymphoma is the main differential diagnosis of CT reported from developed countries (Manzardo et al, 2005). While, focal forms of cerebral tuberculosis (tuberculoma and, less likely tuberculous brain abscess) allow for differential diagnosis of CT mainly in developing countries (Trujillo et al, 2005). Primary CNS lymphoma usually presents with a CD4 count of less than 50 cells/cumm, CT occurs below 100 cells/cumm, and cerebral TB is more frequently present with a CD4 count above 200 cells/cumm (Vidal et al, 2004a;Vidal et al, 2005a;Vidal et al, 2005b).…”

HIV-associated neuromuscular weakness syndrome in Brazil: report of the two first cases

“…Three months after discharge, she was walking without difficulty, presented normal muscular strength in the lower limbs, and had normal lactate levels (1.5 mmol/l), Cd4 cell count=123/mm 3 , and HIV RNA levels <400 copies/ml. Seven months after discharge, she was asymptomatic and maintained normal levels of lactate (1.2 mmol/l) along with Cd4 cell count=206/mm 3 and HIV RNA levels <400 copies/ ml. Figure 1 shows the main laboratory results and their temporal association with the use of HAART.…”

“…Muscular strength in the lower limbs was grade 4, she continued to have absent ankle reflexes, and diminished vibratory sensitivity. At this point, her lactate levels were 2.5 mmol/l, Cd4 cell count 60/ mm 3 , and HIV RNA levels=179,000 copies/ml (5.25 log 10 ). Tenofovir, efavirenz atazanavir and ritonavir were started.…”

“…Serum lactate was 6.6 mmol/l. Cd4 cell count was 62/mm 3 and HIV RNA levels <400 copies/ml. Nerve conduction studies of lower limbs revealed evidence of severe axonal sensory motor polyneuropathy, with signs of denervation affecting distal and proximal segments.…”

“…Antiretroviral therapy has also decreased the incidence of central nervous system (CNS) opportunistic diseases 2 , which vary geographically 3 . However, toxic events secondary to use of HAART can be observed globally.…”