CD8+ encephalitis: a severe but treatable HIV-related acute encephalopathy. Issue 1 (1st November 2016)

• Record Type: Journal Article
• Authors: Zarkali, Angeliki; Gorgoraptis, Nikos; Miller, Robert; John, Laurence; Merve, Ashirwad; Thust, Stefanie; Jager, Rolf; Kullmann, Dimitri; Swayne, Orlando
• Is Part Of: Practical neurology. Volume 17:Issue 1(2017)
• Page Start: 42
• Page End: 46
• Publication Date: 2016-11-01
• Subjects: Confusion -- CD8+ encephalitis -- HIV; Neurology -- Periodicals; 616.8005
• DOI: 10.1136/practneurol-2016-001483
• Languages: English
• ISSNs: 1474-7758

Abstract

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.