1. CD8+ encephalitis: a severe but treatable HIV-related acute encephalopathy
- Author
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Robert F. Miller, Angeliki Zarkali, Orlando B.C. Swayne, Stefanie Thust, Nikos Gorgoraptis, Dimitri M. Kullmann, Rolf Jager, Laurence John, and Ashirwad Merve
- Subjects
0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Pathology ,AIDS Dementia Complex ,Encephalopathy ,Central nervous system ,Acute encephalopathy ,Anti-Inflammatory Agents ,Human immunodeficiency virus (HIV) ,CD8-Positive T-Lymphocytes ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Adrenal Cortex Hormones ,medicine ,Humans ,Progressive encephalopathy ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,030104 developmental biology ,medicine.anatomical_structure ,Anti-Retroviral Agents ,Acute Disease ,Female ,Neurology (clinical) ,business ,Viral load ,030217 neurology & neurosurgery ,CD8 ,Encephalitis - Abstract
Rapidly progressive encephalopathy in an HIV-positive patient presents a major diagnostic and management challenge. CD8+ encephalitis is a severe but treatable form of HIV-related acute encephalopathy, characterised by diffuse perivascular and intraparenchymal CD8+ lymphocytic infiltration. It can occur in patients who are apparently stable on antiretroviral treatment and probably results from viral escape into the central nervous system. Treatment, including high-dose corticosteroids, can give an excellent neurological outcome, even in people with severe encephalopathy and a very poor initial neurological status. We report a woman with CD8+ encephalitis, with a normal CD4 count and undetectable serum viral load, who made a good recovery despite the severity of her presentation.
- Published
- 2016
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