Human immunodeficiency virus (HIV)-induced disease of the central nervous system: pathology and implications for pathogenesis.

摘要: Significant contributions from many different groups during the last 2 or 3 years have characterized relatively uniform neuropathological changes of CNS in AIDS patients. They feature human immunodeficiency virus (HIV)-induced multinucleated giant cells as a histopathological hallmark and HIV demonstrable by electron microscopy, immunocytochemistry, situ hyridization. Unfortunately, varying confusing terminology is used to designate these which been reported surprisingly incidences. Focal lesions microgranulomatous appearance were designated multifocal cell encephalitis subacute encephalitis, may be confused with nodular caused cytomegalovirus. For some authors, latter designation also covers characteristic diffuse white matter termed progressive leukoencephalopathy others, overlap focal lesions. Pathological features HIV-induced syndromes other data do not support major cytopathic effect on neural cells; rather, they suggest secondary pathogenetic events involving predominant type lesion, monocyte/macrophage/microglia. However, low-level, latent, persisting infections cannot excluded at present; then serve an early infected reservoir. A detailed correlation clinical symptoms stage infection currently lacking but urgently needed. The presence HIV-receptor (CD4) molecule brain controversial; similarly, putative cross-reaction proteins trophic substances transmitters needs substantiated.