Roullet E
Department of Neurology, Hôpital Tenon, Paris, France.
J Neurol. 1999 Apr;246(4):237-43. doi: 10.1007/s004150050341.
Toxoplasma encephalitis, cryptococcal meningitis, progressive multifocal leukoencephalopathy (PML), and cytomegalovirus (CMV) encephalitis are the most common opportunistic infections of the central nervous system (CNS) in HIV-infected patients. They occur at variable degrees of immunosuppression, and their diagnosis is based on a systematic evaluation with includes, in a definite order, ongoing prophylactic therapies, extraneurological signs, neuroimaging and CSF studies, and an anti-Toxoplasma therapeutic trial. Concurrent neurological HIV-CNS disease (such as the AIDS dementia complex) is frequent. The development of reliable molecular biology techniques such as the polymerase chain reaction and their application to the CSF have made the diagnosis of virus-related opportunistic infections much easier and has limited the need for cerebral biopsy. The incidence of opportunistic infections has decreased since the introduction of recent antiretroviral therapeutic strategies.
弓形虫脑炎、隐球菌性脑膜炎、进行性多灶性白质脑病（PML）和巨细胞病毒（CMV）脑炎是HIV感染患者中枢神经系统（CNS）最常见的机会性感染。它们在不同程度的免疫抑制情况下发生，其诊断基于系统评估，按一定顺序包括正在进行的预防性治疗、神经外体征、神经影像学和脑脊液检查，以及抗弓形虫治疗试验。同时存在的神经HIV-CNS疾病（如艾滋病痴呆综合征）很常见。可靠的分子生物学技术如聚合酶链反应的发展及其在脑脊液中的应用，使病毒相关机会性感染的诊断变得容易得多，并减少了脑活检的必要性。自从采用近期的抗逆转录病毒治疗策略以来，机会性感染的发生率有所下降。
