[The neurology of HIV infection: clinical features of HIV encephalopathy and future problems in the HAART era]

Abstract

Since the introduction of highly active antiretroviral therapy (HAART), which has been available for most patients in developed world, HIV/AIDS has become a chronic disorder with dramatic reduction in mortality and morbidity due to HIV/AIDS and related diseases. However, from the nationwide survey of HIV-related neurological complications and analysis of our series of total 290 AIDS patients before and after HAART introduction, main neurological complications and opportunistic infections of AIDS patients remain unchanged after the introduction of HAART in Japan. It is crucial that we let a people know that the prevention and treatment of HIV infection is impotant. Recent epidemiological studies show that neurological complications still remain in an important cause of disability, although their relative incidence as their course and clinical presentation have been modified. It is expected that the clinical features of HIV encephalopathy will change particularly from severe subacute progressive dementia in the terminal stage of HIV infection into different patterns of dementia, for example slowly progressive neurological deficits occurring without immune deficiency under HAART.