HIV-1-associated encephalopathy and myelopathy

HIV-1-associated encephalopathy (HIVE) remains an important manifestation o f advanced HIV infection despite recent progress in antiretroviral therapy. This is in part due to particular pharmacological and virological characte ristics of the central nervous system (CNS). HIVE is characterized by a,,su bcortical" dementia with psychomotor slowing as well as memory and concentr ation deficits. An invariable finding are deficits of central motor functio n. Pathogenetically, an enhanced viral replication in immunocompetent CNS c ells is believed to be a requirement. This leads to neurotoxic effects dire ctly elicited by viral products as well as indirectly by the immune respons e to virus infection. HIV-1 myelopathy (HIVM) is the other CNS manifestion of late HIV infection. The present consensus paper recommends diagnostic an d therapeutic procedures in HIVE and HIVM and outlines the current research .