PMID- 33868143
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240331
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 12
DP  - 2021
TI  - HIV-Associated CD8 Encephalitis: A UK Case Series and Review of 
      Histopathologically Confirmed Cases.
PG  - 628296
LID - 10.3389/fneur.2021.628296 [doi]
LID - 628296
AB  - HIV-associated CD8-encephalitis (HIV-CD8E) is a severe inflammatory disorder 
      dominated by infiltration of the brain by CD8(+) T-lymphocytes. It occurs in 
      people with HIV, typically when the virus is apparently well-controlled by 
      antiretroviral treatment (ART). HIV-CD8E presents with symptoms and signs related 
      to marked cerebral inflammation and swelling, and can lead to coma and death 
      unless treated promptly with corticosteroids. Risk events such as intercurrent 
      infection, antiretroviral therapy interruption, immune reconstitution 
      inflammatory syndrome (IRIS) after starting ART, and concomitant associations 
      such as cerebrospinal fluid (CSF) HIV viral escape have been identified, but the 
      pathogenesis of the disorder is not known. We present the largest case series of 
      HIV-CD8E to date (n = 23), representing histopathologically confirmed cases in 
      the UK. We also summarize the global literature representing all previously 
      published cases with histopathological confirmation (n = 30). A new variant of 
      HIV-CD8E is described, occurring on a background of HIV encephalitis 
      (HIVE).Together these series, totalling 53 patients, provide new insights. CSF 
      HIV viral escape was a frequent finding in HIV-CD8E occurring in 68% of those 
      with CSF available and tested; ART interruption and IRIS were important, both 
      occurring in 27%. Black ethnicity appeared to be a key risk factor; all but two 
      UK cases were African, as were the majority of the previously published cases in 
      which ethnicity was stated. We discuss potential pathogenic mechanisms, but there 
      is no unifying explanation over all the HIV-CD8E scenarios.
CI  - Copyright (c) 2021 Lucas, Wong, Nightingale and Miller.
FAU - Lucas, Sebastian B
AU  - Lucas SB
AD  - Department of Cellular Pathology, Guys and St. Thomas' NHS Foundation Trust, 
      London, United Kingdom.
FAU - Wong, Kum T
AU  - Wong KT
AD  - Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, 
      Malaysia.
FAU - Nightingale, Sam
AU  - Nightingale S
AD  - Department of Neurology, University of Cape Town, Cape Town, South Africa.
FAU - Miller, Robert F
AU  - Miller RF
AD  - Centre for Clinical Research in Infection and Sexual Health, Institute for Global 
      Health, University College London, London, United Kingdom.
AD  - Clinical Research Department, Faculty of Infectious and Tropical Diseases, London 
      School of Hygiene and Tropical Medicine, London, United Kingdom.
AD  - Mortimer Market Centre, Central and North West London NHS Foundation Trust, 
      London, United Kingdom.
LA  - eng
PT  - Journal Article
DEP - 20210401
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC8047670
OTO - NOTNLM
OT  - CD8 encephalitis
OT  - HIV
OT  - antiretroviral therapy
OT  - autopsy
OT  - brain
OT  - corticosteroids
OT  - immune reconstitution inflammatory syndrome
OT  - viral escape
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest. The reviewer GM declared a shared affiliation, with no 
      collaboration, with one of the authors SN to the handling Editor.
EDAT- 2021/04/20 06:00
MHDA- 2021/04/20 06:01
PMCR- 2021/04/01
CRDT- 2021/04/19 06:21
PHST- 2020/11/11 00:00 [received]
PHST- 2021/03/11 00:00 [accepted]
PHST- 2021/04/19 06:21 [entrez]
PHST- 2021/04/20 06:00 [pubmed]
PHST- 2021/04/20 06:01 [medline]
PHST- 2021/04/01 00:00 [pmc-release]
AID - 10.3389/fneur.2021.628296 [doi]
PST - epublish
SO  - Front Neurol. 2021 Apr 1;12:628296. doi: 10.3389/fneur.2021.628296. eCollection 
      2021.