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November 12, 1997

AIDS and the Nervous System

Author Affiliations

Mayo Clinic Arizona Scottsdale

JAMA. 1997;278(18):1540. doi:10.1001/jama.1997.03550180094049

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Although the blood-brain barrier protects the major portion of the nervous system from the buffeting winds of opportunistic infection, the central nervous system (CNS) is not immune to the consequences of human immunodeficiency virus (HIV) infection. Among the most common opportunistic infections defining the acquired immunodeficiency syndrome (AIDS) are two with special propensity for the CNS: toxoplasmosis and cryptococcosis.

Over the one and a half decades that have marked the AIDS pandemic, many infections and other conditions have been observed to have a particular tropism for the nervous system. We are now familiar with such previous rarities as progressive multifocal leukoencephalopathy, cytomegaloviral retinitis and encephalitis, and primary CNS lymphoma. Indeed, it is unusual for a patient with HIV infection to escape neural damage from HIV or from one or more opportunistic infections or neoplasms. As