Gavrylov A. Clinical and morphological features of infectious CNS lesions in HIV-infected individuals

The paper presents new data of the role of EBV in the structure of infectious lesions of the CNS in HIV-infected individuals and comparative analysis of cerebral toxoplasmosis, tuberculosis M/ME and EBV M/ME. The main etiological factors were EBV, T. gondii and M. tuberculosis. In EBV infection were dominated psychomotor agitation against mild meningeal syndrome, aphasia; in toxoplasmosis lesion – cramp and vestibular syndromes, decreased visual acuity and memory impairment; in tuberculous – manifestations of meningeal syndrome dominated the focal neurological symptoms. In CSF with the lowest content of lymphocytes in lesions of toxoplasmosis etiology; in tuberculosis – a significant increase in protein, level reduction of glucose and chloride. The highest level of CD4+ cells observed in EBV lesion of the CNS, the lowest – in toxoplasmosis. In EBV coinfection were detected signs of sub acute giant cells encephalitis with areas of demyelinization, low astrogliosis, the development of productive vasculitis with thrombosis. In cerebral toxoplasmosis necrotizing encephalitis/meningoencephalitis was developed and against the background of astrogliosis microglial nodules and micro cysts were formed and vasculitis. The lesion of the corticomedullary junction were found. In M. tuberculosis lesion of the CNS were found edema, gliosis, trombovasculitis, small focal hemorrhage, formation of the tubercular granulomas.