Publication Abstract Display
Type: Published Manuscript
Title: Special issue dedicated to the topic of HIV. Introduction.
Authors: Everall IP, Grant I
Year: 2008
Publication: International Review of Psychiatry
Volume: 20 Issue: Pages: 1
Abstract:This special issue of the International Review of Psychiatry, which is dedicated to the topic of HIV, is a reflection of how much has changed in this disease area in the quarter century that has elapsed since the AIDS epidemic began. Back in 1981 when case reports began to appear of previously rare opportunistic infections occurring in otherwise healthy gay men the recognition of a new fatal disorder was characterized by a spectacular destruction of the immune system that left those affected vulnerable to an array of systemic infections. Only as our understanding of AIDS grew was the causative viral agent, human immunodeficiency virus (HIV), identified as well as a realization that the brain was also a major target for infection and damage. In the pre-treatment era of AIDS the effects on the brain were encapsulated by primary inflammatory pathology due to HIV, which clinically resulted in a range of cognitive dysfunction up to and including a florid dementia, as well as secondary pathology due to opportunistic infections and brain tumors such as non-Hodgkin`s lymphoma. The advent of effective antiretroviral therapy substantially altered the natural history of HIV infection with major reductions in mortality allowing infected individuals to live considerably longer. Thus a new set of challenges have appeared for both researchers and clinicians engaged in the understanding and treatment of HIV and its central nervous system related disorders. These contemporary challenges are reflected in the composition and contents of the papers included in this review. Essentially they can be divided in to three different areas: HIV biology and neuropathology; clinical issues of HIV neurocognitive impairment; and thirdly, co-morbid severe mental illness and their treatment in the setting of HIV infection. The first area outlines our current knowledge of the biology of HIV as it relates to the nervous system and how the neuropathology has changed as infected individuals live longer and age. These topics are covered by the papers by Hult et al.

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