NEUROLOGICAL MANIFESTATIONS OF HIV: UPDATE

Abstract

HIV-associated neurological manifestations compromise the central nervous system (CNS) and peripheral nervous system (PNS), resulting in complications such as encephalitis, progressive multifocal leukoencephalopathy (PML), HIV-associated dementia, and peripheral neuropathies. These conditions stem from inflammation and neurotoxicity induced by the virus, affecting immune and supportive cells such as microglia and astrocytes. This study conducted a systematic review using the Research Portal of the Virtual Health Library, with a search limited to Brazilian articles that addressed neurological alterations in HIV. Ten articles were selected based on strict inclusion criteria. The results pointed to representative data on the prevalence, pathophysiology, and available therapies for neurological complications of HIV, highlighting the persistence of neurocognitive disorders even in patients on antiretroviral therapy (ART). While PML was evidenced as a significant complication, with a low survival rate among those affected. The discussion reinforces that, despite the advances in ART, factors such as advanced age, prolonged immunosuppression, and barriers to drug penetration in the CNS contribute to the persistence of neurocognitive changes. Personalized therapeutic strategies, combined with multidisciplinary integration, are essential for the management of these patients. It is concluded that the neurological complications of HIV remain a relevant clinical challenge. Continuous research and the development of more effective therapies are indispensable to improve the quality of life of patients and reduce the impacts of these manifestations.