Central nervous system pathology in pediatric AIDS

D. W. Dickson, J. F. Llena, S. J. Nelson, Karen M. Weidenheim

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Children with AIDS frequently have neurological manifestations due to complications of immunodeficiency or intrinsic effects of human immunodeficiency virus type 1 (HIV-1) on the central nervous system (CNS). The most common neurological disorders not directly related to HIV-1 infection include cerebrovascular disease and lymphoma. Global anoxic-ischemic and necrotizing encephalopathies are frequent, while CNS hemorrhages and arteriopathies are less frequent. Opportunistic CNS infections are uncommon, limited predominantly to monilial and cytomegaloviral encephalitides. Only a few cases of CNS toxoplasmosis have been reported in children. CNS lymphomas often occur in the setting of systemic polymorphous, polyclonal B-cell proliferations that have been associated with Epstein-Barr virus infection. Intrinsic effects of HIV-1 on the CNS include microcephaly, diffuse gliosis, basal ganglia mineralization, HIV encephalitis, and corticospinal tract degeneration. Although viral antigens can be detected in microglia and multinucleated cells in HIV encephalitis, most of the CNS effects of HIV-1 infection cannot be attributed to detectable levels of viral antigen, suggesting that the pediatric CNS is unusually susceptible to low-level HIV-1 infection or to systemic effects of HIV-1 infection, possibly mediated by soluble factors, including the inflammatory cytokines, interleukin-1β, and tumor necrosis factor-α, which have been shown to be increased in serum and cerebrospinal fluid of children with AIDS.

Original languageEnglish (US)
Pages (from-to)93-106
Number of pages14
JournalAnnals of the New York Academy of Sciences
Volume693
DOIs
StatePublished - 1993

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Pediatrics
Neurology
Pathology
HIV-1
Viruses
Acquired Immunodeficiency Syndrome
Central Nervous System
Virus Diseases
Encephalitis
Viral Antigens
Lymphoma
Cerebral Toxoplasmosis
HIV
Brain Hypoxia-Ischemia
Cerebrovascular Disorders
Central Nervous System Infections
Microcephaly
Pyramidal Tracts
Epstein-Barr Virus Infections
Gliosis

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Central nervous system pathology in pediatric AIDS. / Dickson, D. W.; Llena, J. F.; Nelson, S. J.; Weidenheim, Karen M.

In: Annals of the New York Academy of Sciences, Vol. 693, 1993, p. 93-106.

Research output: Contribution to journalArticle

Dickson, D. W. ; Llena, J. F. ; Nelson, S. J. ; Weidenheim, Karen M. / Central nervous system pathology in pediatric AIDS. In: Annals of the New York Academy of Sciences. 1993 ; Vol. 693. pp. 93-106.
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