CNS Manifestations of HIV/AIDS: A Review of Neuroimaging Features

SUMMARY: HIV and AIDS cause a wide range of pathology in the CNS, including direct sequelae of HIV viral infection, opportunistic infections and characteristic neoplasms in the immunocompromised host, and treatment-related effects, many of which can overlap in their clinical and imaging features. Although the incidence of opportunistic infection has decreased with the advent of highly active antiretroviral therapy, familiarity with the CNS manifestations of HIV/AIDS remains critical for timely diagnosis and treatment of these patients, particularly among populations without consistent access to antiretrovirals. Here, we provide a pictorial review of manifestations of HIV/AIDS in the brain and spine, with attention to key imaging features that can help radiologists appropriately narrow and prioritize the differential diagnosis.