Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
PRIMARY INFECTION WITH HUMAN IMMUNODEFICIENCY VIRUS
AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 183-201, 1988.. Unique Identifier : AIDSLINE ICDB/89648468 McArthur JC; Johnson RT; Dept. of Neurology, The Johns Hopkins Sch. of Medicine, 600 North; Wolfe St., Meyer 6-109, Baltimore, MD 21205
Abstract:
It is clear that HIV has neurotropic properties. Invasion of the nervous system may occur at an early stage of infection with the virus. HIV and the lentivirus family are described and the possible pathogenetic mechanisms of the neurological diseases that may involve direct infection of neural tissues by HIV in patients with AIDS are discussed. The lentiviruses are a distinct subfamily of nononcogenic retroviruses that produce cellular damage or lysis rather than transformation. They cause persistent infections and chronic diseases in their natural hosts. Typically, there is a long incubation period and often gradual progression of disease. HIV is morphologically and genomically similar to visna virus, the prototypical lentivirus. Primary HIV infections affecting the CNS include acute atypical meningitis, AIDS-related dementia, AIDS-related myelopathies, painful sensory neuropathy, and possible immune disorders. An understanding of the characteristics of lentiviruses is critical for understanding the tropism of HIV for the T4 lymphocyte and the persistent infection that ensues. Tropism for monocytes and macrophages and for cells within the CNS is suspected. AIDS-related dementia, one of the most frequently noted neurological manifestations, affecting up to 70% of patients, probably represents early invasion of the CNS by HIV, and unchecked viral replication within the brain. The possibility that HIV enters the brain during the earliest stages of infection, even around the time of seroconversion, has major implications for the design and use of antiviral agents. Understanding of the role of retroviruses in producing neurological disease is increasing rapidly, and the efforts being made to delineate and define AIDS-related disorders may have important implications for explaining other neurological conditions. (106 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*MICROBIOLOGY Animal Brain/MICROBIOLOGY Dementia/ETIOLOGY Human HIV/CLASSIFICATION/PHYSIOLOGY/PATHOGENICITY Meningitis/ETIOLOGY Nervous System Diseases/*ETIOLOGY Opportunistic Infections/ETIOLOGY Peripheral Nerves/MICROBIOLOGY Risk Factors Spinal Cord/MICROBIOLOGY 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.
