J Neuropathol Exp Neurol. 2007 Sep;66(9):799-808
Characterization of Human Immunodeficiency Virus (HIV)-Infected Cells in Infiltrates Associated With CNS Opportunistic Infections in Patients With HIV Clade C Infection
Mahadevan A, Shankar SK, Satishchandra P, Ranga U, Chickabasaviah YT, Santosh V, Vasanthapuram R, Pardo CA, Nath A, Zink MC
From the Departments of Neuropathology (AM, SKS, YTC, VS), Neurology (PS), and Neurovirology (RV), National Institute of Mental Health and Neurological Sciences, Bangalore, India; Molecular Virology Laboratory (UR), Molecular Biology and Genetics Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur, Bangalore, India; and Departments of Neurology (CAP, AN) and Molecular and Comparative Pathobiology (MCZ), The Johns Hopkins University, Baltimore, Maryland.
Infection with human immunodeficiency virus (HIV) clade C is the most common HIV infection worldwide, yet its impact on the nervous system remains largely unknown. Autopsy studies from regions affected by this virus are scarce, and HIV dementia has only rarely been reported from these countries. Most patients who develop neurologic complications die of opportunistic infections. We thus conducted a neuropathologic study from a single institution in India to characterize the HIV-infected cells in the inflammatory infiltrates in a total of 15 cases (5 patients each who died of either CNS toxoplasmosis, tuberculosis, or cryptococcal meningitis). Nearly, all patients had HIV-infected cells in the brain, although these cells were most abundant in patients with toxoplasma encephalitis. Interestingly, none of the patients had any multinucleated giant cells. HIV-infected cells were found in the parenchyma, perivascular regions, and choroid plexus and found infiltrating the parenchyma from the meninges, suggesting multiple portals of entry into the brain. These findings suggest the possibility that patients, even if successfully treated for an opportunistic inflection, may be at high risk of developing HIV encephalitis and subsequent dementia.
PMID: 17805010 [PubMed - as supplied by publisher]