Top
This volume reviews the latest findings on the neurological and psychiatric complications of human immunodeficiency virus type 1 (HIV-1) infection and the acquired immunodeficiency syndrome (AIDS). The book focuses chiefly on the pathogenesis and clinical aspects of a primary neurological disorder - known as the AIDS dementia complex (ADC), HIV cognitive-motor complex, HIV dementia, and, in children, HIV encephalopathy - which is caused by HIV-1 itself rather than by an opportunistic organism. The studies presented shed new light on the interactions of HIV-1 with the brain and, more generally, on the pathogenesis of viral and immunological diseases of the central nervous system.
Coverage begins with background information on the principal pathogenic forces involved in causing brain dysfunction in ADC, i.e., HIV-1 neurotropism, immune system interactions with viruses, and cytokine circuits in the brain. A major portion of the book examines the neuropathology and pathogenesis of ADC and identifies targets for novel therapeutic strategies. This section includes studies on the role of macrophages and microglia in HIV-related neuropathology: the neuronal changes observed in HIV encephalitis; the relationship of cytokine expression to ADC pathogenesis; and the role of amino acid excitotoxicity in mediating neuronal injury. Two chapters highlight relevant experimental findings on neuropathology and viral neurotropism in simian immunodeficiency virus infection, an animal model of HIV-1 infection.
The book includes extensive discussions of the clinical aspects of HIV-related neurological and psychiatric disorders. Noted psychiatrists review their experience with depression and other psychiatric disorders in HIV-infected patients and offer guidelines for evaluation and treatment. Other contributors examine the epidemiology, risk factors, and natural history of ADC and describe current methods for evaluating ADC in adults. Close attention is also given to the pathogenesis, clinical features, diagnosis, and management of HIV encephalopathy in infants and children.
HIV, AIDS, and the Brain is a vitally important source of information for neurologists, psychiatrists, neuroscientists, infectious disease specialists, virologists, and immunologists. It will serve as a milestone in understanding the AIDS dementia complex and a stimulus for research both on ADC and on other viral diseases of the nervous system.
