The Acquired Immunodeficiency Syndrome (AIDS) Dementia Complex

The acquired immunodeficiency syndrome (AIDS) demen-tia complex is a frequent and devastating complication of infection with human immunodeficiency virus-type 1 (HIV-1). Features of the AIDS dementia complex include de-creased memory, the inability to concentrate, apathy, and psychomotor retardation. Typical neuropathologic findings include gliosis, focal necrosis of neurons, perivascular in-flammation, formation of microglial nodules, multinucleated giant cells, and demyelination. That HIV-1 is the direct cause of this neurologic syndrome is strongly supported by the available evidence. In addition, several studies have iden-tified the monocyte-macrophage as the predominant cell type in the brain infected with HIV-1. However, the mecha-nisms by which the infected monocytes-macrophages medi-ate neurologic dysfunction and destruction nave not been elucidated