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Through a Glass, Darkly

Through a Glass, Darkly EDITORIAL Cerebrospinal Fluid Viral Load Measurements and the Pathogenesis of Human Immunodeficiency Virus Infection of the Central Nervous System HE NEUROLOGICAL manifestations of hu- autopsy evidence of HIV encephalitis. The annual in- man immunodeficiency virus (HIV) in- cidence of HIV dementia was approximately 7% in pa- fection are a major source of morbidity and tients with AIDS but has dropped by 50% since the in- mortality despite advances in antiretrovi- troduction of highly active antiretroviral therapy. T ral therapy. Viral invasion of the central In this issue of the ARCHIVES, Ellis et al describe a nervous system (CNS) occurs as an extremely early event prospective study that looked at the utility of CSF HIV 1,2 following HIV infection, yet, generally, productive in- RNA levels as a predictor of future progression to neu- fection is uncommon until later in HIV/acquired immu- ropsychological impairment in HIV-infected individu- nodeficiency syndrome (AIDS), after the development of als. This study represents a logical progression from prior immunosuppression. In approximately 10% of pa- work indicating that CSF HIV-1 RNA levels were el- tients, initial (acute) HIV infection is associated with acute evated in cognitively impaired subjects compared with 20,23-25 self-limited meningitis or encephalitis, although it http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Neurology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6149
eISSN
2168-6157
DOI
10.1001/archneur.59.6.909
Publisher site
See Article on Publisher Site

Abstract

EDITORIAL Cerebrospinal Fluid Viral Load Measurements and the Pathogenesis of Human Immunodeficiency Virus Infection of the Central Nervous System HE NEUROLOGICAL manifestations of hu- autopsy evidence of HIV encephalitis. The annual in- man immunodeficiency virus (HIV) in- cidence of HIV dementia was approximately 7% in pa- fection are a major source of morbidity and tients with AIDS but has dropped by 50% since the in- mortality despite advances in antiretrovi- troduction of highly active antiretroviral therapy. T ral therapy. Viral invasion of the central In this issue of the ARCHIVES, Ellis et al describe a nervous system (CNS) occurs as an extremely early event prospective study that looked at the utility of CSF HIV 1,2 following HIV infection, yet, generally, productive in- RNA levels as a predictor of future progression to neu- fection is uncommon until later in HIV/acquired immu- ropsychological impairment in HIV-infected individu- nodeficiency syndrome (AIDS), after the development of als. This study represents a logical progression from prior immunosuppression. In approximately 10% of pa- work indicating that CSF HIV-1 RNA levels were el- tients, initial (acute) HIV infection is associated with acute evated in cognitively impaired subjects compared with 20,23-25 self-limited meningitis or encephalitis, although it

Journal

JAMA NeurologyAmerican Medical Association

Published: Jun 1, 2002

References