HEADACHE AND HIV-INFECTION - A SYSTEMATIC REVIEW

The etiology and epidemiology of the different headache types occurrin g during HIV infection and the changes of preexisting primary headache types during HIV infection are reviewed on the basis of published con trolled studies and of own epidemiological studies. Headache during HI V infection may occur as a symptom of aseptic meningitis with an incre asing frequency during the stages of infection. This headache is simil ar to tension-type headache and can be regarded as an HIV-associated h eadache. Opportunistic infections and neoplasms can lead to headache b y inflammatory mechanisms or by increasing intracranial pressure. Anti retroviral treatment can lead to headache as a drug-related side effec t. Preexisting migraine decreases in frequency and intensity during th e HIV infection whereas preexisting tension-type headache seems to inc rease. Management of headache during HIV infection is not different fr om the management in non-infected headache patients, however, an under treatment of pain in HIV infected patients has been shown. Iri severe cases, pain treatment should be performed in specialised clinics in or der to improve the quality of life as long as possible.