CLINICAL IMPACT OF CYTOMEGALOVIRUS INFECTIONS OF THE NERVOUS-SYSTEM IN PATIENTS WITH AIDS

被引:24
作者
MCCUTCHAN, JA
机构
[1] Department of Medicine, University of California, San Diego, CA
关键词
D O I
10.1093/clinids/21.Supplement_2.S196
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Cytomegalovirus (CMV) causes five distinct neurological syndromes in patients with AIDS: retinitis, myelitis/polyradiculopathy, encephalitis with dementia, ventriculoenceopalitis, and mononeuritis multiplex. The clinical syndromes associated with CMV ventriculoencephalitis and diffuse encephalitis in patients with AIDS have only recently been clearly described despite the fact that multiple neuropathologic descriptions of CMV in the brain have been published over the past decade, Even more-subtle levels of cognitive impairment have been detected in patients with CMV retinitis who are also at increased risk of developing diffuse CMV encephalitis. Demonstration of CMV DNA in the CSF with use of the polymerase chain reaction may provide both a sensitive and specific method for diagnosis of these syndromes. The effectiveness of aggressive early treatment of CMV syndromes in the nervous system, with the exception of retinitis, is unclear and warrants formal trials.
引用
收藏
页码:S196 / S201
页数:6
相关论文
共 42 条
[1]   DETECTION OF CYTOMEGALOVIRUS IN CEREBROSPINAL-FLUID AUTOPSY SPECIMENS FROM AIDS PATIENTS [J].
ACHIM, CL ;
NAGRA, RM ;
WANG, R ;
NELSON, JA ;
WILEY, CA .
JOURNAL OF INFECTIOUS DISEASES, 1994, 169 (03) :623-627
[2]   CONTROL OF CYTOMEGALOVIRUS RETINITIS USING SUSTAINED-RELEASE OF INTRAOCULAR GANCICLOVIR [J].
ANAND, R ;
NIGHTINGALE, SD ;
FISH, RH ;
SMITH, TJ ;
ASHTON, P .
ARCHIVES OF OPHTHALMOLOGY, 1993, 111 (02) :223-227
[3]   HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION OF THE BRAIN [J].
ATWOOD, WJ ;
BERGER, JR ;
KADERMAN, R ;
TORNATORE, CS ;
MAJOR, EO .
CLINICAL MICROBIOLOGY REVIEWS, 1993, 6 (04) :339-366
[4]   TEMPORAL TRENDS IN THE INCIDENCE OF HTV-1-RELATED NEUROLOGIC DISEASES - MULTICENTER AIDS COHORT STUDY, 1985-1992 [J].
BACELLAR, H ;
MUNOZ, A ;
MILLER, EN ;
COHEN, BA ;
BESLEY, D ;
SELNES, OA ;
BECKER, JT ;
MCARTHUR, JC .
NEUROLOGY, 1994, 44 (10) :1892-1900
[5]   CYTOMEGALOVIRUS POLYRADICULONEUROPATHY IN ACQUIRED-IMMUNE-DEFICIENCY-SYNDROME [J].
BEHAR, R ;
WILEY, C ;
MCCUTCHAN, JA .
NEUROLOGY, 1987, 37 (04) :557-561
[6]   THE DEVELOPMENT OF CYTOMEGALOVIRUS ENCEPHALITIS IN AIDS PATIENTS RECEIVING GANCICLOVIR [J].
BERMAN, SM ;
KIM, RC .
AMERICAN JOURNAL OF MEDICINE, 1994, 96 (05) :415-419
[7]   PCR IDENTIFICATION OF HIV-1 DNA-SEQUENCES IN BRAIN-TISSUE OF PATIENTS WITH AIDS ENCEPHALOPATHY [J].
BONI, J ;
EMMERICH, BS ;
LEIB, SL ;
WIESTLER, OD ;
SCHUPBACH, J ;
KLEIHUES, P .
NEUROLOGY, 1993, 43 (09) :1813-1817
[8]   HIV-Associated Disease of the Nervous System: Review of Nomenclature and Proposal for Neuropathology-Based Terminology [J].
Budka, Herbert ;
Wiley, Clayton A. ;
Kleihues, Paul ;
Artigas, Juan ;
Asbury, Arthur K. ;
Cho, Eun-Sook ;
Cornblath, David R. ;
Dal Canto, Mauro C. ;
DeGirolami, Umberto ;
Dickson, Dennis ;
Epstein, Leon G. ;
Esiri, Margaret M. ;
Giangaspero, Felice ;
Gosztonyi, Georg ;
Gray, Francoise ;
Griffin, John W. ;
Henin, Dominique ;
Iwasaki, Yuzo ;
Janssen, Robert S. ;
Johnson, Richard T. ;
Lantos, Peter L. ;
Lyman, William D. ;
McArthur, Justin C. ;
Nagashima, Kazuo ;
Peress, Nancy ;
Petito, Carol K. ;
Price, Richard W. ;
Rhodes, Roy H. ;
Rosenblum, Marc ;
Said, Gerard ;
Scaravilli, Francesco ;
Sharer, Leroy R. ;
Vinters, Harry V. .
BRAIN PATHOLOGY, 1991, 1 (03) :143-152
[9]   THE PREDICTIVE VALUE OF CYTOMEGALOVIRUS RETINITIS FOR CYTOMEGALOVIRUS ENCEPHALITIS IN ACQUIRED-IMMUNODEFICIENCY-SYNDROME [J].
BYLSMA, SS ;
ACHIM, CL ;
WILEY, CA ;
GONZALEZ, C ;
KUPPERMANN, BD ;
BERRY, C ;
FREEMAN, WR .
ARCHIVES OF OPHTHALMOLOGY, 1995, 113 (01) :89-95
[10]   CYTOMEGALOVIRUS-INFECTION OF THE CENTRAL-NERVOUS-SYSTEM IN PATIENTS WITH AIDS - DIAGNOSIS BY DNA AMPLIFICATION FROM CEREBROSPINAL-FLUID [J].
CINQUE, P ;
VAGO, L ;
BRYTTING, M ;
CASTAGNA, A ;
ACCORDINI, A ;
SUNDQVIST, VA ;
ZANCHETTA, N ;
MONFORTE, AD ;
WAHREN, B ;
LAZZARIN, A ;
LINDE, A .
JOURNAL OF INFECTIOUS DISEASES, 1992, 166 (06) :1408-1411