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Acquired Immunodeficiency Syndrome and the Nervous System

Pietro Cocchi, MD; Cesare Cocchi Jr, MD
JAMA. 1990;263(1):37. doi:10.1001/jama.1990.03440010035020.
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To the Editor.—  As reported by Dalakas and colleagues,1 human immunodeficiency virus (HIV) is not only lymphotropic but also neurotropic and can invade the central and peripheral nervous systems early, resulting in a latent or overt infection.The neurotropism of HIV should not be entirely surprising if this retrovirus is to be considered a human representative of the lentivirus subfamily. The primary neuropathy, which seems to be a direct result of HIV infection of the central nervous system (CNS), has important pathological and clinical implications.In adults, neurological symptoms may sometimes be the sole manifestations of acquired immunodeficiency syndrome.2 In pediatric patients, the CNS is often the primary site of HIV infection rather than the immune system, and the neuropathy may progress even with minimal immunologic abnormalities,3 indicating that neural tissue is a principal target of the retrovirus. In infants and children we have observed intellectual


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