Neurological Manifestations of HIV-1 Infection and Markers for HIV Progression

Abstract

Human immunodeficiency virus, or HIV, is the virus that causes acquired immune deficiency syndrome (AIDS). The acquired immunodeficiency syndrome (AIDS) was first described in 1981 in USA. In 1983, human immunodeficiency virus type-1 (HIV-1) was isolated, and in the following year it was demonstrated clearly that it was the causative agent of AIDS. The disease is a major health problem in many parts of the world. The high prevalence and striking diversi‐ ty of neurological disorders complicating AIDS were recognized in 1983 (Snider et al., 1983). AIDS was associated with distinct neurological syndromes, such as dementia, myelopathy and painful neuropathy that appeared to result from the HIV itself. Over the last 30 years, there has been increasing recognition of the role that auto antibodies play in neurological disorders. Dur‐ ing the past decade, AIDS has become a global health problem with 182,000 000 cases reported from 152 countries. It is estimated that nearly five to ten million people are infected worldwide with HIV-1. With a mean incubation period from time of infection to the development of AIDS of eight to 10 years, it is projected that nearly all HIV-1-infected individual will develop AIDS within the next 15 years (Quinn, 1990). It has become increasingly evident that the vast majori‐ ty of HIV-1 infected people will eventually develop AIDS or an AIDS-related condition (De Wolf and Lange, 1991) with a median time of progression to AIDS of 7-10 years from infection in adults (Lui et al., 1988; Bacchetti and Moss, 1989) and shorter periods in infants and elderly patients (Medley et al., 1987; Auger et al., 1988; Lagakos & DeGruttola, 1989). In the United States alone, 104, 210 cases of AIDS and more than 61,000 deaths have been reported. Sexual, parenteral as well as perinatal transmission routes have remained the major modes of trans‐ mission, although the proportion of cases within each risk behaviour category has changed. Recently, there has been a dramatic increase in the proportion of AIDS patients who have ac‐ knowledged as IV drug user or have heterosexual contact with other individuals at high risk for HIV infection (Quinn, 1990).