Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
THE AIDS DEMENTIA COMPLEX
AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 203-19, 1988.. Unique Identifier : AIDSLINE ICDB/89648469 Price RW; Sidtis JJ; Navia BA; Pumarola-Sune T; Ornitz DB; Dept. of Neurology, Memorial Sloan-Kettering Cancer Inst., New; York, NY 10021
Abstract:
Patients with AIDS are susceptible to a variety of opportunistic infections and neoplasms of the CNS. These patients may also develop a subacute or, more commonly, a chronic progressive CNS disorder characterized by cognitive, motor, and behavioral dysfunction. This disorder, AIDS dementia complex (ADC), is by far the most common CNS complication in persons infected by HIV. The clinical, pathological, and diagnostic features of ADC in adults and its pathobiology are described. Because of the limited knowledge of viral pathogenesis and neurobiology of ADC, the emphasis is on the major questions to be addressed in future work. Topics include clinical features, neuropsychological studies, neurodiagnostic studies, neuropathological correlates, epidemiology and natural history, etiology of HIV infection in the CNS, pathobiology of HIV infection, diagnosis and differential diagnosis, and prospects for prevention and therapy. ADC has emerged in the last 5 years as a major neurological disease. It is very common and it frequently manifests before the major systemic diseases defining AIDS, at times, even in the absence of less severe systemic complications of HIV infection. Over the next several decades, ADC is predicted to become one of the most common severe neurological disorders. At present, treatment of ADC is limited to management of symptoms. Antiviral therapy for AIDS offers some hope for ameliorating ADC. A clear understanding of ADC and similar retroviral infections in animals may well be relevant to other degenerative neurological diseases or even to the major psychoses, including schizophrenia. It is clear that new retroviruses related to HIV and also highly variable mutants are arising. Some will likely infect the nervous system and may or may not cause neurological disorders resembling ADC. (65 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS AIDS-Related Complex/PATHOLOGY Dementia/DIAGNOSIS/*ETIOLOGY Diagnosis, Differential Human HIV/PHYSIOLOGY/PATHOGENICITY Neuropsychological Tests Virus Replication MONOGRAPH REVIEW REVIEW, TUTORIAL
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
