Neurological Manifestations | Psychiatric Comorbidities
Neurological complications of HIV/AIDS are common
and not limited to opportunistic infections (see Table 32–1).
All levels of the neuraxis can be involved and include the brain,
meninges, nerves, and spinal cord. HIV infects macrophages and monocytes
but not other nervous system cells. The brain is a repository for
HIV even when peripheral HIV viral levels are low. HIV may penetrate
into brain tissue as early as 2 weeks after infection. The majority
of patients with advanced HIV/AIDS will live with clinically
evident neurological dysfunction sometime during the course of their illness
(Koppel et al. 1985). In the United States and Europe,
where antiretroviral therapy is relatively available, peripheral
neuropathy and HIV-associated cognitive dysfunction are the most
common neurological sequelae from HIV/AIDS (McGuire 2003).