The neuropathology of HIV: a review of the first 10 years

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Abstract
Since the early 1980s there has been an increasing recognition of the importance of involvement of the brain in HIV infection. It is now known that the brain is infected very early on and that cerebral pathology occurs in approximately 90% of the patients who have died of AIDS. This review will portray the evolution of our understanding during the first 10 years of the epidemic of AIDS. Discussion will concentrate on four main areas. First, there is a description of diseases affecting the brain including opportunistic infections, neoplasms, and pathology directly induced by HIV. Secondly, the significance of these neuropathological abnormalities will be explored by correlating them with clinical findings. Thirdly, the importance of recent quantitative studies of brain cell population changes will be addressed, especially in clarifying HIV-induced neuronal loss. Finally, current theories of the possible mechanisms of neuronal loss will be discussed.