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NEUROLOGY 1987;37:562
© 1987 American Academy of Neurology

Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection

S. M. de la Monte, MD, MPH, D. D. Ho, MD, R. T. Schooley, MD, M. S. Hirsch, MD and E. P. Richardson, Jr., MD

Charles S. Kubik Laboratory of Neuropathology in the James Homer Wright Pathology Laboratory (Drs. de la Monte and Richardson), and the Division of Infectious Diseases in the Department of Medicine (Drs. Ho, Schooley, and Hirsch), Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Subacute encephalitis, characterized by demyelination, gliosis of the gray and white matter, focal necrosis, microglial nodules, atypical oligodendrocyte nuclei, and multinucleation of cells, was present in 27 of 30 (90%) autopsied patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex. Subacute encephalitis was mainly distributed in the frontal (58%) and temporal (69%) lobes, basal ganglia (77%), amygdala (80%), and hippocampus (64%). Ten (37%) with moderate or severe subacute encephalitis were demented; 82% with mild subacute encephalitis had no recognized neurologic disorder. Human T-lymphotropic virus type III (HTLV-III) was isolated from neural tissue or CSF in 11 of 13 patients, 10 with subacute encephalitis, and 1 without CNS lesions. We conclude that subacute encephalitis is common in AIDS patients and is most likely caused by CNS infection with HTLV-III.

Address correspondence and reprint requests to Dr. de la Monte, Division of Neuropathology, Department of Pathology, Massachusetts General Hospital, Fruit Street, Boston, MA 02114.

Received April 28, 1986. Accepted for publication in final form August 12, 1986.




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