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Spine
Diagnosis
Infection and Inflammatory Disorders
Infections
HIV Myelitis
HIV Myelitis
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • AIDS or HIV → myelopathy or myelitis, vacuolar myelopathy (VM)

              • Definitions

                • Myelopathy resulting from primary HIV infection

              IMAGING

              • General Features

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Microscopic Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Levin SN et al: HIV and spinal cord disease. Handb Clin Neurol. 152:213-27, 2018
                                        2. Tali ET et al: Pyogenic spinal infections. Neuroimaging Clin N Am. 25(2):193-208, 2015
                                        3. Andrade P et al: Transverse myelitis and acute HIV infection: a case report. BMC Infect Dis. 14:149, 2014
                                        4. Candy S et al: Acute myelopathy or cauda equina syndrome in HIV-positive adults in a tuberculosis endemic setting: MRI, clinical, and pathologic findings. AJNR Am J Neuroradiol. 35(8):1634-41, 2014
                                        5. Delgado SR et al: CNS demyelinating disorder with mixed features of neuromyelitis optica and multiple sclerosis in HIV-1 infection. Case report and literature review. J Neurovirol. 20(5):531-7, 2014
                                        6. Moulignier A et al: CD8 transverse myelitis in a patient with HIV-1 infection. BMJ Case Rep. 2014, 2014
                                        7. Román GC: Tropical myelopathies. Handb Clin Neurol. 121:1521-48, 2014
                                        8. Hamada Y et al: Primary HIV infection with acute transverse myelitis. Intern Med. 50(15):1615-7, 2011
                                        9. Lyons J et al: Atypical nervous system manifestations of HIV. Semin Neurol. 31(3):254-65, 2011
                                        10. Brunel AS et al: HIV-related immune reconstitution cryptococcal meningoradiculitis: corticosteroid response. Neurology. 2009 Nov 17;73(20):1705-7. Erratum in: Neurology. 74(3):271, 2010
                                        11. Tahir M et al: Immune reconstitution inflammatory syndrome manifesting as disseminated tuberculosis, deep venous thrombosis, encephalopathy and myelopathy. Indian J Chest Dis Allied Sci. 50(4):363-4, 2008
                                        12. Anneken K et al: Recurrent vacuolar myelopathy in HIV infection. J Infect. 52(6):e181-3, 2006
                                        13. Everall IP et al: The shifting patterns of HIV encephalitis neuropathology. Neurotox Res. 8(1-2):51-61, 2005
                                        14. Portegies P et al: Guidelines for the diagnosis and management of neurological complications of HIV infection. Eur J Neurol. 11(5):297-304, 2004
                                        15. Di Rocco A: HIV-associated Myelopathy. Curr Treatment Options Infect Dis. 5:457-465, 2003
                                        16. Aboulafia DM et al: Vacuolar myelopathy and vacuolar cerebellar leukoencephalopathy: a late complication of AIDS after highly active antiretroviral therapy-induced immune reconstitution. AIDS Patient Care STDS. 16(12):579-84, 2002
                                        17. Chong J et al: MR findings in AIDS-associated myelopathy. AJNR Am J Neuroradiol. 20(8):1412-6, 1999
                                        18. Di Rocco A: Diseases of the spinal cord in human immunodeficiency virus infection. Semin Neurol. 19(2):151-5, 1999
                                        19. Quencer RM: AIDS-associated myelopathy: clinical severity, MR findings, and underlying etiologies. AJNR Am J Neuroradiol. 20(8):1387-8, 1999
                                        20. Weiser B et al: Human immunodeficiency virus type 1 expression in the central nervous system correlates directly with extent of disease. Proc Natl Acad Sci U S A. 87(10):3997-4001, 1990
                                        21. Eilbott DJ et al: Human immunodeficiency virus type 1 in spinal cords of acquired immunodeficiency syndrome patients with myelopathy: expression and replication in macrophages. Proc Natl Acad Sci U S A. 86(9):3337-41, 1989
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • AIDS or HIV → myelopathy or myelitis, vacuolar myelopathy (VM)

                                                    • Definitions

                                                      • Myelopathy resulting from primary HIV infection

                                                    IMAGING

                                                    • General Features

                                                      • MR Findings

                                                        • Imaging Recommendations

                                                          DIFFERENTIAL DIAGNOSIS

                                                            PATHOLOGY

                                                            • General Features

                                                              • Staging, Grading, & Classification

                                                                • Microscopic Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Levin SN et al: HIV and spinal cord disease. Handb Clin Neurol. 152:213-27, 2018
                                                                              2. Tali ET et al: Pyogenic spinal infections. Neuroimaging Clin N Am. 25(2):193-208, 2015
                                                                              3. Andrade P et al: Transverse myelitis and acute HIV infection: a case report. BMC Infect Dis. 14:149, 2014
                                                                              4. Candy S et al: Acute myelopathy or cauda equina syndrome in HIV-positive adults in a tuberculosis endemic setting: MRI, clinical, and pathologic findings. AJNR Am J Neuroradiol. 35(8):1634-41, 2014
                                                                              5. Delgado SR et al: CNS demyelinating disorder with mixed features of neuromyelitis optica and multiple sclerosis in HIV-1 infection. Case report and literature review. J Neurovirol. 20(5):531-7, 2014
                                                                              6. Moulignier A et al: CD8 transverse myelitis in a patient with HIV-1 infection. BMJ Case Rep. 2014, 2014
                                                                              7. Román GC: Tropical myelopathies. Handb Clin Neurol. 121:1521-48, 2014
                                                                              8. Hamada Y et al: Primary HIV infection with acute transverse myelitis. Intern Med. 50(15):1615-7, 2011
                                                                              9. Lyons J et al: Atypical nervous system manifestations of HIV. Semin Neurol. 31(3):254-65, 2011
                                                                              10. Brunel AS et al: HIV-related immune reconstitution cryptococcal meningoradiculitis: corticosteroid response. Neurology. 2009 Nov 17;73(20):1705-7. Erratum in: Neurology. 74(3):271, 2010
                                                                              11. Tahir M et al: Immune reconstitution inflammatory syndrome manifesting as disseminated tuberculosis, deep venous thrombosis, encephalopathy and myelopathy. Indian J Chest Dis Allied Sci. 50(4):363-4, 2008
                                                                              12. Anneken K et al: Recurrent vacuolar myelopathy in HIV infection. J Infect. 52(6):e181-3, 2006
                                                                              13. Everall IP et al: The shifting patterns of HIV encephalitis neuropathology. Neurotox Res. 8(1-2):51-61, 2005
                                                                              14. Portegies P et al: Guidelines for the diagnosis and management of neurological complications of HIV infection. Eur J Neurol. 11(5):297-304, 2004
                                                                              15. Di Rocco A: HIV-associated Myelopathy. Curr Treatment Options Infect Dis. 5:457-465, 2003
                                                                              16. Aboulafia DM et al: Vacuolar myelopathy and vacuolar cerebellar leukoencephalopathy: a late complication of AIDS after highly active antiretroviral therapy-induced immune reconstitution. AIDS Patient Care STDS. 16(12):579-84, 2002
                                                                              17. Chong J et al: MR findings in AIDS-associated myelopathy. AJNR Am J Neuroradiol. 20(8):1412-6, 1999
                                                                              18. Di Rocco A: Diseases of the spinal cord in human immunodeficiency virus infection. Semin Neurol. 19(2):151-5, 1999
                                                                              19. Quencer RM: AIDS-associated myelopathy: clinical severity, MR findings, and underlying etiologies. AJNR Am J Neuroradiol. 20(8):1387-8, 1999
                                                                              20. Weiser B et al: Human immunodeficiency virus type 1 expression in the central nervous system correlates directly with extent of disease. Proc Natl Acad Sci U S A. 87(10):3997-4001, 1990
                                                                              21. Eilbott DJ et al: Human immunodeficiency virus type 1 in spinal cords of acquired immunodeficiency syndrome patients with myelopathy: expression and replication in macrophages. Proc Natl Acad Sci U S A. 86(9):3337-41, 1989