Emerging views of NeuroAIDS

Abstract

More than 40 million people are infected with human immunodeficiency virus type 1 (HIV-1), with an estimated death toll of over 3·5 million. Despite preventive efforts, the epidemic continues to spread, and more than 20% of all individuals infected with HIV will develop neurological complications. HIV/AIDS and the Nervous System comprehensively discusses the neurological and psychiatric manifestations of HIV. Many of the leading international researchers and clinicians in the various disciplines of neuroAIDS have contributed to this logical and concisely organised text. The authors should be complemented on the overall layout and style. The book is divided into 19 chapters that deal with the neuroepidemiology of HIV/AIDS, the neurological complications (including neurocognitive, myelopathy, peripheral neuropathy, and infections), and the possible treatment paradigms that are currently available. Of note, the chapter that describes the molecular virology of HIV—how the virus might enter the brain, and where and why it might become resident in the nervous system—provides an excellent summary of the current state of basic-science research on neuroAIDS. The chapter that focuses on neuropsychological testing and possible interpretation of results is extremely useful for both clinicians and neuropsychologists. The final chapter, which deals with possible neuropharmacology, provides an in-depth assessment of current treatment paradigms and highlights possible adjunctive therapies. Each of the chapters has black and white figures and diagrams, which are supplemented by five pages of full-colour plates at the end of the book. The figures and tables throughout the book help to present concepts that are often complicated in a clear and easy-to-understand way. An extensive reference list, usually ending in 2005, supplements each chapter and provides ample opportunity for additional reading. The book is up to date and serves as a condensed companion to the definitive textbook on this subject, Neurology of AIDS by Gendelman, Grant, Everall, Lipton, and Swindells. In fact, many of the same authors have written chapters for both books. Future editions of this book might benefit from a chapter on the neurological and psychiatric complications of HIV in children and adolescents. There is some redundancy throughout the book; in particular, the section on neuroimaging could be integrated into other chapters on neuroinfections. A chapter that details the various neuroimaging modalities, such as magnetic resonance spectroscopy, functional magnetic resonance imaging, positron emission tomography, and single-photon emission computed tomography, might be helpful. This outstanding but expensive book provides a balanced account of current knowledge in the clinical and basic-science aspects of the neuropsychiatric manifestations of HIV infection. HIV/AIDS and the Nervous System is essential for students, residents, researchers, and clinicians who care for patients with HIV.