Multiform CNS complications accompany HIV infection. Some neurologic conditions are caused by antiretroviral drugs. In addition, AIDS patients are susceptible to the same neurologic diseases as patients who do not have HIV infection. In AIDS, a clinical presentation often cannot be explained with a single diagnosis. New-onset neurologic complications often are superimposed on an ongoing process with a different etiology.
Clinical features reflect the sum of deficits at several anatomic sites.
The manifestations of AIDS and its neurologic complications differ in children, whose immune and nervous systems are infected at an immature stage, whether in utero, during delivery, or postpartum. Neurologic involvement in HIV infection is more frequent in children than in adults. It may take the form of a loss of previously acquired intellectual and motor milestones or of developmental delay. Opportunistic infections due to reactivation of dormant organisms are unusual, as children may not have been exposed yet to the responsible organisms. Distinguishing features include blood vessel calcification in the basal ganglia, large necrotizing cortical and subcortical lesions, microcephaly, and infection of astrocytes.