Human Immunodeficiency Virus and the Central Nervous System

Human immunodeficiency virus (HIV) continues to infect large numbers of people, including children, worldwide. The virus produces much of its clinical impact by infecting cellular components of the immune system. However, HIV also has the propensity to infect the brain, where it can induce substantial pathology and impair brain function. Highly active antiretroviral therapy has reduced the severity and prevalence of HIV-associated neurocognitive disorders. Nevertheless, substantial morbidity and mortality continue to stem from HIV infection of the nervous system. This article reviews the pathogenesis of HIV-induced central nervous system disease, the pathological and clinical effects of HIV infection within the brain, and the controversies and challenges of the use of highly active antiretroviral therapy for prevention and treatment of HIV-induced central nervous system dysfunction.