CNS diseases in AIDS

on 30.1.09 with 0 comments

    • Toxoplasmosis

      • See behavior changes and lots of small abscesses on MRI

      • Almost always treated for in AIDS patients

      • Lots of small abscesses throughout the brain

    • HIV encephalitis

      • Direct infection of brain by HIV (crosses the BBB in macrophages)

      • Seen in 20-30% of AIDS patients

      • See multinucleated giant cells, especially perivascularly

    • AIDS dementia complex

      • Clinical syndrome due to direct CNS infection of brain (still crosses BBB in macrophages)

      • HIV not in neurons, but in microglia (which migrated in as tissue macrophages?) and astrocytes

      • Mechanism unknown because there’s not too much neuronal damage

      • May see some gliosis and vacuolization of the white matter

    • Vacuolar myelopathy

      • Degenerative disease of the spinal cord seen in 20-30% of AIDS patients

      • Maybe due to direct infection of spinal cord by HIV

      • Looks like subacute combined degeneration seen with vitamin B12 deficiency (affects the posterior and lateral columns of the spinal cord), but it’s not associated with deficiency

    • Meningitis (often cryptococcal)

    • Progressive multifocal leukoencephalopathy – is an opportunistic brain infection in AIDS patients caused by JC virus which infects the oligodendrocytes and causes MS-like c/s

Category: Pathology Notes



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