HIV
encephalitis
Epidemiology and Etiology:
- HIV aseptic
meningitis occurs in 10% of patients
- Infects
mononuclear and multinucleated macrophages and microglia
- Neurons and oligodendrocytes are not infected (but may be damaged
indirectly by cytokines and BBB
alterations)
Common sites:
- Subcortical white matter
- Diencephalons
- brainstem
Gross features:
- mild ventricular
dilation
- mild sulcal widening
- normal cortical
thickness
Histologic features:
- chronic
inflammatory reaction
- microglial nodules widely distributed
- multinucleated
giant cells (macrophage-derived)
- also
found in the vicinity of small blood vessels
- associated
tissue necrosis sometimes
- reactive gliosis sometimes
- small blood
vessels with abnormally prominent endothelila
cells
- perivascular foamy or pigment-laden macrophages
- may see:
- multifocal or diffuse areas of myelin pallor
- associated
axonal swellings and gliosis
Immunophenotype:
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Marker:
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Sensitivity:
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Specificity:
|
|
HIV immunostain
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Molecular features:
Other features:
- AIDS dementia
complex:
- Insidious
onset of dementia
- Mood
disturbances
- Motor
abnormalities
- Ataxia
- Bladder
and bowel incontinence
- seizures
References: