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  • Updated 10.31.2018
  • Released 10.31.2018
  • Expires For CME 10.31.2021

AIDS and HIV: neurologic manifestations and complications

Introduction

Overview

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.

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