A REVIEW OF NEURONAL DAMAGE IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION- ITS ASSESSMENT, POSSIBLE MECHANISM AND RELATIONSHIP TO DEMENTIA

Over the past decade it has been realized that HIV affects the central nervous system, and various investigations have illuminated the spect rum of neuropathology in AIDS. One major advance has been the demonstr ation that there is substantial neuronal loss, which appears independe nt of the HIV-associated inflammatory lesions. Quantitative studies on neuronal populations, while fraught with methodological difficulties, are essential to the understanding of the mechanism of this neurotoxi c damage. This article will review, firstly, the modem stereological p rocedures available for quantitative investigations; secondly, the pat tern, degree and time scale of HIV-associated neuronal loss; thirdly, other morphological evidence of neuronal damage; and finally, the path ological and clinical implications of these findings.