The CNS manifestations of HIV/AIDS (neuroAIDS) occur secondary to a wide range of neurodegenerative, infectious, inflammatory, or neoplastic processes.
Epidemiology
Since the introduction of antiretroviral therapy (ART) in 1996, there has been a shift in the epidemiology of CNS manifestations of HIV in Western developed countries, with a decline in the incidence of opportunistic infections 2,3.
Pathology
HIV/AIDS affects the CNS by one of four mechanisms:
direct consequence of the HIV virus
opportunistic infections
neoplasms in the immunocompromised host
treatment-related complications
Direct consequences
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HIV-associated neurocognitive disorders (HANDs)
HIV-associated dementia with findings appreciable on MRI (previously known as AIDS dementia complex)
HIV vasculopathy - striking non-atherosclerotic fusiform ectasia of the major intracranial arteries can occur, usually in children with congenital HIV/AIDS. Associated with large hemispheric stroke
Opportunistic infections
toxoplasmosis (most common)
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fungal infections
candida
bacterial