Journal Article

Acute Meningoencephalitis in Chronic Human Immunodeficiency Virus (HIV) Infection: Putative Central Nervous System Escape of HIV Replication

Karen A. Wendel and Justin C. McArthur

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 8, pages 1107-1111
Published in print October 2003 | ISSN: 1058-4838
Published online October 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/378300
Acute Meningoencephalitis in Chronic Human Immunodeficiency Virus (HIV) Infection: Putative Central Nervous System Escape of HIV Replication

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We describe 3 patients with chronic human immunodeficiency virus (HIV) infection who presented with syndromes compatible with acute meningoencephalitis secondary to HIV; these syndromes were characterized by elevated cerebrospinal spinal fluid (CSF) HIV viral loads and T2-weighted signal abnormalities on magnetic resonance imaging of the brain. After the initiation of or a change in highly active antiretroviral therapy (HAART), each of the patients had significant and rapid improvement in neurologic symptoms and dramatic reductions in CSF HIV viral loads. Although further investigation is needed, these findings suggest that measurement of CSF HIV viral load and treatment with central nervous system–penetrating HAART should be considered for patients with acute neurologic complaints, chronic HIV infection, and no other identifiable cause of neurologic illness.

Journal Article.  3207 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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