HIV-1-related central nervous system disease: current issues in pathogenesis, diagnosis, and treatment

Cold Spring Harb Perspect Med. 2012 Jun;2(6):a007120. doi: 10.1101/cshperspect.a007120.


HIV-associated central nervous system (CNS) injury continues to be clinically significant in the modern era of HIV infection and therapy. A substantial proportion of patients with suppressed HIV infection on optimal antiretroviral therapy have impaired performance on neuropsychological testing, suggesting persistence of neurological abnormalities despite treatment and projected long-term survival. In the underresourced setting, limited accessibility to antiretroviral medications means that CNS complications of later-stage HIV infection continue to be a major concern. This article reviews key recent advances in our understanding of the neuropathogenesis of HIV, focusing on basic and clinical studies that reveal viral and host features associated with viral neuroinvasion, persistence, and immunopathogenesis in the CNS, as well as issues related to monitoring and treatment of HIV-associated CNS injury in the current era.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • AIDS Dementia Complex / diagnosis
  • AIDS Dementia Complex / drug therapy
  • AIDS Dementia Complex / virology
  • Anti-HIV Agents / therapeutic use
  • Antiretroviral Therapy, Highly Active
  • Biomarkers
  • Central Nervous System Viral Diseases* / diagnosis
  • Central Nervous System Viral Diseases* / drug therapy
  • Central Nervous System Viral Diseases* / virology
  • Cognition Disorders / virology
  • HIV Infections* / diagnosis
  • HIV Infections* / drug therapy
  • HIV-1*
  • Humans
  • Virus Internalization


  • Anti-HIV Agents
  • Biomarkers