AIDS and HIV: neurologic manifestations and complications

Beau K Nakamoto MD (

Dr. Nakamoto of the University of Hawaii received research grants from the National Institutes of Health and Neuraltus Pharmaceuticals Inc as a principal investigator.

John E Greenlee MD, editor. (

Dr. Greenlee of the University of Utah School of Medicine has no relevant financial relationships to disclose.

Originally released January 5, 2015; last updated October 31, 2018; expires October 31, 2021


Early treatment with combination antiretroviral therapy (cART) is recommended in all patients diagnosed with HIV to prevent HIV-associated neurologic complications. Neurologists need to be familiar with the breadth of HIV-associated neurologic manifestations to facilitate timely diagnosis and treatment. Combination antiretroviral therapy-related toxicities, drug-drug interactions, and neurologic complications associated with immune reconstitution need to be considered when caring for this population.

This article provides a broad overview of the neurologic manifestations and complications encountered in HIV-infected individuals.

Key points


• HIV can affect the entire nervous system including the brain, spinal cord, motor neuron, peripheral nerve, neuromuscular junction, and muscles.


• Although neurologic complications associated with opportunistic infections are less common in treated HIV-infected individuals, the burden of neurologic disease persists and develops at a younger age.


• The most common neurologic manifestations of HIV are HIV-associated neurocognitive disorders and neuropathy; however, diseases traditionally associated with aging (eg, cerebrovascular disease) are becoming increasingly important.


• Neurologists should be aware of specific neurologically relevant toxicities and drug-drug interactions associated with cART.


• Neurologic manifestations of immune reconstitution inflammatory syndrome must be recognized when HIV-infected individuals are started on cART.

The content you are trying to view is available only to logged in, current MedLink Neurology subscribers.

If you are a subscriber, please log in.

If you are a former subscriber or have registered before, please log in first and then click select a Service Plan or contact Subscriber Services. Site license users, click the Site License Acces link on the Homepage at an authorized computer.

If you have never registered before, click Learn More about MedLink Neurology  or view available Service Plans.