Narrative review reveals variable neuroinvasive risk and diagnostic delays in people with HIV, highlighting the need for molecular testing during severe immunosuppression.
Key Points
To evaluate whether HIV infection alters susceptibility to West Nile virus, increases the severity of neuroinvasive disease, or impairs standard diagnostic test accuracy.
Conducted structured literature searches across PubMed/MEDLINE and Scopus up to August 2026, supplemented by targeted citation searching.
Identified and evaluated 23 peer-reviewed publications reporting clinical outcomes or seroepidemiological data on West Nile virus in people with HIV.
Neutralization-confirmed West Nile virus antibodies were identified in 3.0% of 2843 people with HIV in an Italian cohort, with no neuroinvasive cases or links to immunological parameters.
Comparative US cohort data demonstrated that HIV status alone does not confer a uniform excess risk of neuroinvasive disease.
Severe neuroinvasive disease in advanced HIV infection was linked to delayed or absent antibody responses, requiring molecular confirmation.