Neurological Presentations of HIV Infection

Original Editor - Cindy John-Chu

Top Contributors - Cindy John-Chu and Kim Jackson  

Introduction

The Human Immunodefeciency Virus (HIV) is a virus known to attack cells of the body's immune system thus, causing the body to become prone to opportunistic infections.[1] HIV infection can also lead to neurologic complications as the the virus belongs to a class of viruses ( the lentiviruses) that are known to pose a high risk of developing chronic neurologic diseases in their human hosts.[2]

[3]

Aetiology

The immunodefeciency virus is able to cause damage to the Central Nervous System (CNS) having crossed through the blood brain barrier. Neurological conditions from HIV infection can occur throughout the various stages of the infection[4]. However, they may occur commonly at the clinical stages III and IV[5]. There are three possible mechanisms by which the HIV infection can damage the nervous system. They are through:

  1. Direct HIV infection
  2. Opportunistic infections
  3. Autoimmunity[5]

Neurologic Presentations of HIV

Neurological disorders consequent of HIV infection include the following:

  • Spastic paraparesis
  • Peripheral neuropathies (e.g. Distal symmetric polyneuropathy)
  • Polyradiculopathy
  • Neuropathy
  • Myelopathy
  • Seizures
  • HIV-associated dementia
  • Stroke[2][6]

The presence of these conditions is largely dependent on the clinical stage of the patient and the degree of underlying immunosuppression[5]

Implications for Physiotherapy

The similarities between the nervous system complications of HIV and other neurological conditions call for thorough assessment of patients with neurological disorders to ascertain the underlying cause of their conditions. This would be resourceful to guide future research in these areas.

References

  1. HIV.gov. What Are HIV and AIDS? Available from: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids (accessed 17 September, 2020).
  2. 2.0 2.1 McGuire D/ University of California San Francisco. Neurologic Manifestations of HIV: HIV Insite Knowledge Base Chapter June 2003. Available from: https://hivinsite.ucsf.edu/Insite?page=kb-04-01-02 (accessed 17 September, 2020).
  3. Med School Made Easy. How HIV Infects Cells: an Introduction. Available from: https://www.youtube.com/watch?v=40sCHrOZ9zQ [last accessed 19/9/2020]
  4. Modi G, Mochan A and Modi M. Neurological Manifestations of HIV. In: Okware SI (ed.) Advances in HIV and AIDS Control. Rijeka InTech 2018. Available from: https://www.intechopen.com/books/advances-in-hiv-and-aids-control/neurological-manifestations-of-hiv (accessed 18 September, 2020)
  5. 5.0 5.1 5.2 Howlett PW. Neurological Disorders in HIV in Africa: A Review. African Health Sciences. 2019; 19(suppl 2): A Review. African Health Sciences. 2019; 19(suppl2):1953-1977.
  6. Patrick CK. Neurological Complications of HIV Infection. Available from: https://www.aids.gov.hk/pdf/g190htm/19.htm (accessed 18 September, 2020)