The neurology of HIV infection--a review of the literature

The nervous system is widely involved in the course of infection with the human immunodeficiency virus (HIV). The manifestation may be a direct effect of the virus, the result of opportunistic infections or secondary malignancies, or a result of the therapy of various aspects of the disease. This review looks at these neurological consequences of HIV infection. The review was sourced mainly by Medline search using the search terms HIV, AIDS and neurology. Relevant journals were subsequently studied. The major neurological manifestations of HIV infection are toxoplasmosis, cryptococcal meningitis, AIDS dementia complex, primary lymphoma, tuberculosis, progressive multifocal leukoencephalopathy, herpes zoster, Bells palsy, peripheral neuropathy, and vacuolar myelopathy. The overall effect of these is the acceleration of progression of the disease. About 30% of the mortality in HIV infection is attributed to neurological diseases. The nervous system is significantly affected in HIV infection and the impact on morbidity and mortality is profound. All effort should be made to ensure early recognition and amelioration of the various nervous systems complications of HIV infection.