PMID- 23221843
OWN - NLM
STAT- MEDLINE
DCOM- 20130510
LR  - 20220316
IS  - 1538-6899 (Electronic)
IS  - 1080-2371 (Print)
IS  - 1080-2371 (Linking)
VI  - 18
IP  - 6 Infectious Disease
DP  - 2012 Dec
TI  - Neurologic complications of HIV-1 infection and its treatment in the era of 
      antiretroviral therapy.
PG  - 1319-37
LID - 10.1212/01.CON.0000423849.24900.ec [doi]
AB  - PURPOSE OF REVIEW: Neurologic complications of HIV infection are unfortunately 
      common, even in the era of effective antiretroviral treatment (ART). The 
      consulting neurologist is often asked to distinguish among neurologic 
      deterioration due to opportunistic infection (OI), immune reconstitution, or the 
      effect of the virus itself, and to comment on the role of immunomodulatory agents 
      in patients with HIV infection. Additionally, as successful virologic control has 
      extended the life span of patients with HIV infection, neurologists are called 
      upon to manage long-term complications, such as neurocognitive disorders and 
      peripheral neuropathy. RECENT FINDINGS: Despite the use of ART, significant 
      numbers of patients continue to be affected by HIV-associated neurocognitive 
      disorders, although with milder forms compared to the pre-ART era. Regimens of 
      ART have been ranked according to CNS penetration and are being studied with 
      regard to neuropsychological outcomes. Nucleoside analogs with the greatest 
      potential for peripheral neurotoxicity are no longer considered first-line agents 
      for HIV treatment. Efavirenz, a non-nucleoside reverse transcriptase inhibitor, 
      has the greatest frequency of neurologic side effects among newer ART regimens. 
      The spectrum of clinical manifestations of immune reconstitution inflammatory 
      syndrome (IRIS) continues to grow, including IRIS without underlying OI. A 
      greater understanding of pathophysiology and risk factors has shown that while 
      HIV should be treated early to prevent severe immunocompromise, delayed 
      initiation of ART may be helpful while treating OIs. SUMMARY: This article 
      reviews the neurologic complications of HIV infection, or its treatment, most 
      commonly encountered by neurologists.
FAU - Kranick, Sarah M
AU  - Kranick SM
AD  - National Institutes of Health, Building 10, 6-5700, Bethesda, MD 20892, USA. 
      mattes1@ninds.nih.gov
FAU - Nath, Avindra
AU  - Nath A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Continuum (Minneap Minn)
JT  - Continuum (Minneapolis, Minn.)
JID - 9509333
RN  - 0 (Anti-HIV Agents)
RN  - 0 (Anticonvulsants)
RN  - 0 (Immunologic Factors)
RN  - 0 (Reverse Transcriptase Inhibitors)
SB  - IM
MH  - AIDS-Related Opportunistic Infections/virology
MH  - Anti-HIV Agents/adverse effects/*therapeutic use
MH  - Anticonvulsants/therapeutic use
MH  - Central Nervous System Bacterial Infections/drug therapy/virology
MH  - Central Nervous System Fungal Infections/drug therapy/virology
MH  - Central Nervous System Parasitic Infections/drug therapy/virology
MH  - Central Nervous System Viral Diseases/drug therapy/*virology
MH  - Cognition Disorders/drug therapy/virology
MH  - Drug Therapy, Combination
MH  - Female
MH  - HIV Infections/*drug therapy
MH  - *HIV-1
MH  - Herpesviridae Infections/drug therapy/virology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/drug therapy/virology
MH  - Immunologic Factors/therapeutic use
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Polyneuropathies/drug therapy/virology
MH  - Reverse Transcriptase Inhibitors/adverse effects
MH  - Tomography, X-Ray Computed
PMC - PMC3760534
EDAT- 2012/12/12 06:00
MHDA- 2013/05/11 06:00
PMCR- 2013/12/01
CRDT- 2012/12/11 06:00
PHST- 2012/12/11 06:00 [entrez]
PHST- 2012/12/12 06:00 [pubmed]
PHST- 2013/05/11 06:00 [medline]
PHST- 2013/12/01 00:00 [pmc-release]
AID - 00132979-201212000-00010 [pii]
AID - CON18606 [pii]
AID - 10.1212/01.CON.0000423849.24900.ec [doi]
PST - ppublish
SO  - Continuum (Minneap Minn). 2012 Dec;18(6 Infectious Disease):1319-37. doi: 
      10.1212/01.CON.0000423849.24900.ec.