DEMENTIA IN HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE - A REVIEW

From review of the literature it can be concluded that human immunodeficiency vims (HIV) dementia presents a distinct clinical entity with cognitive, motoric, and behavioral impairments, apparently caused by the neurotoxic effect of HIV. Histopathologic investigations demonstrate a unique combination of white matter atrophy and multinuclear cell infiltration. Functional imaging methods, such as electroencephalography (EEG), positron emission tomography (PET), and, especially, single-photon emission computed tomography (SPECT) are superior to morphologic methods (computed tomography, magnetic resonance imaging) in demonstrating early stages. The brain is infected early, apparently already a few months after seroconversion, but cognitive impairments seldom develop in asymptomatic stages, even years after infection. HIV dementia occurs typically at the same time as immunosuppression, and most AIDS patients develop the condition in late stages.