HIV-Mediated CD8 Encephalitis: Adding Fuel to the Immune-Dysregulation Fire

HIV-mediated immune dysregulation frequently affects the central nervous system (CNS) and contributes to both HIV-associated neurocognitive disease and CNS immune reconstitution inflammatory syndrome (IRIS). Recently, a subacute encephalitis hallmarked by CD8 cells and not attributable to other infectious causes or IRIS has emerged. In a retrospective study, researchers explored the clinical and pathological features of this condition in 14 patients, of whom 2 were diagnosed with IRIS.

The patients' mean CD4 count during the 6 months before symptom onset was 369 cells/mm³. Among the patients for whom information was available, all but one (diagnosed with IRIS) had increasing plasma and detectable cerebrospinal fluid viral loads at the time o…