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Human immunodeficiency virus associated central nervous system infections
  1. M. E. Torok
  1. Clinical Research Fellow, Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, District 5, Ho Chi Minh City, Vietnam; E-mail: etorok{at}hcm.vnn.vn

    Abstract

    INTRODUCTION

    Neurological disease is common in human immunodeficiency virus (HIV) infected individuals, affecting 39–70% of symptomatic patients (Janssen 1997; Simpson & Tagliati 1994). In advanced disease, involvement of the central nervous system (CNS) is a frequent problem and may be due to HIV infection itself, or may be caused by opportunistic pathogens or malignancies. The presentations of these disorders are overlapping and non-specific. The prompt diagnosis of potentially treatable CNS opportunistic infections is crucial, but is often limited by the lack of diagnostic tests of sufficient sensitivity and specificity, particularly in the developing world. Furthermore, treatment may be complicated by the need to treat the HIV infection in addition to the opportunistic infection. The optimal time to initiate antiretroviral therapy in CNS opportunistic infections remains unknown (Torok et al. 2005). In the developed world, the introduction of highly active antiretroviral therapy (HAART) has altered the epidemiology of these diseases

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