HIV-Dementia

A Review Thirty Five Years After (1981-2015)

Abstract

In this review, the intention is to present the four clinical models of HIV-1-brain damage, named with the diffuse category of HIV-encephalopathy. It contains the past three decades, since the first static-infectological model of Snider WD, developed in 1983, based in a great neuropathological trial with AIDS patients. The second one, maybe the most compact of them, was the AIDS-dementia complex, published by the Navia BA group, in two notable papers published in 1986. This resulted in a consistent HIV-neuropsychiatric condition, till 1996, when HAART era begun. In a third early-HAART evolving model, we can find good correlations between the different levels: clinical (mild-moderate/severe forms), neuropsychological (subcortical pattern), neuroimaging, and LCR-markers. In the last-current paradigm, coincident with the advanced HAART treatments, the original HIV-encephalopathy became in a hybrid-complex compartimentalized condition, in contact with other neurodegenerative entities, like Alzheimer disease, Parkinson disease or the CNS-immune reconstitution inflammatory syndrome, with a high prevalence, atypical clinical forms, and with the demand of a specific management, in parallel to the systemic HIV disease.