NEUROLOGICAL MANIFESTATIONS OF HIV

Question 1

What are the opportunistic infections affecting the neurological system that are associated with HIV infection?

Answer 1

Toxoplasmosis - encephalitis and abscesses

Cryptococcus neoformans (fungus) - meningitis

JC virus - progressive multifocal leucoencephalopathy (PML)

CMV - retinitis, encephalitis, cauda equina syndrome, vasculitic neuropathy

Mycobacterium tuberculosis - meningitis, abscesses

Question 2

What are the neurological tumours associated with HIV?

Answer 2

Primary cerebral lymphoma

Metastatic systemic lymphoma

Question 3

What are the virus specific HIV related disorders that affect the neurological system?

Answer 3

HIV associated neurocognitive disorders (HAND) - dementia

Vacuolar myelopathy

Peripheral neuropathy

Polymyositis

Question 4

What are the HIV associated drug induced neurological complications?

Answer 4

Neuropathy - didanosine, stavudine, isoniazid

Myalgia, myopathy - NRTIs

Immune reconstitution inflammatory syndrome (IRIS)

Compartmentalization syndrome (low plasma viral loads but high CSF viral loads)

Question 5

At what CD4 counts do toxoplasmosis and cryptococcal meningitis occur?

Answer 5

Below 200 cells/microlitre