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Acquired HIV Encephalitis
Miral D. Jhaveri, MD; James M. Provenzale, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Diagnostic Checklist

          TERMINOLOGY

          • Definitions

            • HIV-1 encephalitis/encephalopathy (HIVE)
            • Direct HIV infection of brain
              • Opportunistic infections absent
              • Cognitive, behavioral, motor abnormalities in 25-70%
              • HIV-associated neurocognitive disorders (HAND) = most frequent neurological manifestations of HIV infection
            • Moderate cognitive impairment common despite good virologic response to therapy

          IMAGING

          • General Features

            • CT Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Bilgrami M et al: Neurologic diseases in HIV-infected patients. Handb Clin Neurol. 121:1321-44, 2014
                                        2. Mahan M et al: Neuroimaging of viral infections of the central nervous system. Handb Clin Neurol. 123:149-73, 2014
                                        3. Clifford DB et al: HIV-associated neurocognitive disorder. Lancet Infect Dis. 13(11):976-86, 2013
                                        4. Dahiya S et al: Genetic variation and HIV-associated neurologic disease. Adv Virus Res. 87:183-240, 2013
                                        5. Risacher SL et al: Neuroimaging biomarkers of neurodegenerative diseases and dementia. Semin Neurol. 33(4):386-416, 2013
                                        6. Crews L et al: Molecular Pathology of Neuro-AIDS (CNS-HIV). Int J Mol Sci. 10(3):1045-63, 2009
                                        7. Letendre SL et al: Neurologic complications of HIV disease and their treatment. Top HIV Med. 17(2):46-56, 2009
                                        8. Ragin AB et al: Whole brain diffusion tensor imaging in HIV-associated cognitive impairment. AJNR Am J Neuroradiol. 25(2):195-200, 2004
                                        9. Graham CB 3rd et al: Screening CT of the brain determined by CD4 count in HIV-positive patients presenting with headache. AJNR Am J Neuroradiol. 21(3):451-4, 2000
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • HIV-1 encephalitis/encephalopathy (HIVE)
                                                  • Direct HIV infection of brain
                                                    • Opportunistic infections absent
                                                    • Cognitive, behavioral, motor abnormalities in 25-70%
                                                    • HIV-associated neurocognitive disorders (HAND) = most frequent neurological manifestations of HIV infection
                                                  • Moderate cognitive impairment common despite good virologic response to therapy

                                                IMAGING

                                                • General Features

                                                  • CT Findings

                                                    • MR Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            • Staging, Grading, & Classification

                                                              • Gross Pathologic & Surgical Features

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Bilgrami M et al: Neurologic diseases in HIV-infected patients. Handb Clin Neurol. 121:1321-44, 2014
                                                                              2. Mahan M et al: Neuroimaging of viral infections of the central nervous system. Handb Clin Neurol. 123:149-73, 2014
                                                                              3. Clifford DB et al: HIV-associated neurocognitive disorder. Lancet Infect Dis. 13(11):976-86, 2013
                                                                              4. Dahiya S et al: Genetic variation and HIV-associated neurologic disease. Adv Virus Res. 87:183-240, 2013
                                                                              5. Risacher SL et al: Neuroimaging biomarkers of neurodegenerative diseases and dementia. Semin Neurol. 33(4):386-416, 2013
                                                                              6. Crews L et al: Molecular Pathology of Neuro-AIDS (CNS-HIV). Int J Mol Sci. 10(3):1045-63, 2009
                                                                              7. Letendre SL et al: Neurologic complications of HIV disease and their treatment. Top HIV Med. 17(2):46-56, 2009
                                                                              8. Ragin AB et al: Whole brain diffusion tensor imaging in HIV-associated cognitive impairment. AJNR Am J Neuroradiol. 25(2):195-200, 2004
                                                                              9. Graham CB 3rd et al: Screening CT of the brain determined by CD4 count in HIV-positive patients presenting with headache. AJNR Am J Neuroradiol. 21(3):451-4, 2000