Neuropathology of HIV/AIDS with an overview of the Indian scene
Shankar, S.K.; Mahadevan, A.; Satishchandra, P.; Kumar, R.Uday.; Yasha, T.C.; Santosh, V.; Chandramuki, A.; Ravi, V.; Nath, A.
Indian Journal of Medical Research 121(4): 468-488
2005
ISSN/ISBN: 0019-5340 PMID: 15817957 Document Number: 257221
Neurological manifestations of HIV infection and AIDS are being recognized with a frequency that parallels the increasing number of AIDS cases. Next to sub-Saharan Africa, India has the second largest burden of HIV-related pathology, essentially caused by HIV-1 clade C. But the true prevalence of HIV-related neuroinfections and pathology is not available due to inadequate medical facilities, social stigma, and ignorance that lead to underdiagnosis. Neurotuberculosis, cryptococcosis and toxoplasmosis are the major neuropathologies, which manifest clinically by reactivation of latent infection. Despite the heavy burden of HIV/AIDS, HIV-associated neoplasia is infrequent, including primary central nervous system lymphomas. HIV encephalitis and HIV-associated dementia are considered infrequent. Peripheral neuropathy usually manifests with vasculitic neuropathy, while diffuse infiltrative lymphocytosis syndrome involving nerves has not been reported from India. Spinal cord pathology including vacuolar myelopathy is rare, even in asymptomatic cases. Until now, AIDS cases in India are drug naive, but a new cohort of cases receiving HAART therapy is emerging, altering the biology and evolution of HIV/AIDS in India. The epidemiology, diagnosis and biology of HIV/AIDS are outlined.