Important note: Information in this article was accurate in July 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; July 15, 2002
Michael Greer, Senior Medical Writer
T. Dianne Langford and colleagues at the University of California and the Veterans Affairs San Diego Health Care System in San Diego investigated "a severe form of demyelinating HIV-associated leukoencephalopathy in AIDS patients failing highly active antiretroviral therapy (HAART)."
Temporary HAART-induced immune recovery may have created conditions conducive to HIV brain infiltration and subsequent white matter degeneration, Langford and coauthors found.
The researchers examined autopsy data from seven HIV patients who developed leukoencephalopathy after failing HAART. These subjects typically demonstrated poor immunological function and viral control at the time of death, with most showing signs of HIV-associated dementia in addition to leukoencephalopathy, according to the report.
The autopsied patients suffered from advanced white matter degeneration including myelin loss, axonal damage, and neurogliosis, study data showed. Brain tissue from the patients carried high HIV viral loads coupled with extensive infiltration by HIV-specific immune cells.
The limited immune recovery provided by unsuccessful HAART appeared to enable perivascular infiltration by infected monocytes, inducing progressive white matter degradation (Severe, demyelinating leukoencephalopathy in AIDS patients on antiretroviral therapy, AIDS 2002 May 3;16(7):1019-29.
"Taken together, our findings provide evidence for the emergence of a severe form of HIV-associated leukoencephalopathy," Langford and colleagues concluded. "This condition warrants further study and increased vigilance among those who provide care for HIV-infected individuals."
The corresponding author for this report is Eliezer Masliah, University of California-San Diego, Dept. of Neuroscience, La Jolla, CA 92093, USA.
A search at www.NewsRx.net using the term "AIDS and HIV therapy" yielded 1146 articles in 28 specialized reports.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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