Evidence map›Paper›PMID 27786246›Full record

ReviewNature reviews. Neurology2016

HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment.

Lauren N Bowen, Bryan Smith, Daniel Reich, Martha Quezado, Avindra Nath

Abstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 2 pooled it
8.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 2 syntheses or guidelines pooled it, 224 citations in OpenAlex.

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  19. Neurovirulent Pathogens Across the Human Lifespan: A Balancing Act.Journal of the Pediatric Infectious Diseases Society · 2025
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42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Lauren N BowenSection of Infections of the Nervous System, National Institute for Neurologic Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10/7C103, Bethesda, Maryland 28092, USA.
Bryan SmithSection of Infections of the Nervous System, National Institute for Neurologic Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10/7C103, Bethesda, Maryland 28092, USA.
Daniel ReichTranslational Neuroradiology Unit, National Institute for Neurologic Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10/5C103, Bethesda, Maryland 20892, USA.
Martha QuezadoDepartment of Pathology, National Cancer Institute, National Institutes of Health, 10 Center Drive, Building 10 Magnuson CC 2A10, Bethesda, Maryland 20892, USA.
Avindra NathSection of Infections of the Nervous System, National Institute for Neurologic Disorders and Stroke, National Institutes of Health, 10 Center Drive, Building 10/7C103, Bethesda, Maryland 28092, USA.
National Institutes of Health · USNational Institute of Neurological Disorders and Stroke · US

Funding

Neuropathogenesis of Retroviral InfectionsZIANS003130 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI NATH, AVINDRA · 2011 to 2025
$73.7M
Multimodal MRI in Multiple SclerosisZIANS003119 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI REICH, DANIEL · 2010 to 2025
$53.4M
6 · The paper itself

Abstract

Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mortality of infections. The clinical and radiographic pattern of CNS opportunistic infections is unique in the setting of HIV infection: opportunistic infections in HIV-positive patients often have characteristic clinical and radiological presentations that can differ from the presentation of opportunistic infections in immunocompetent patients and are often sufficient to establish the diagnosis. ART in the setting of these opportunistic infections can lead to a paradoxical worsening caused by an immune reconstitution inflammatory syndrome (IRIS). In this Review, we discuss several of the most common CNS opportunistic infections: cerebral toxoplasmosis, progressive multifocal leukoencephalopathy (PML), tuberculous meningitis, cryptococcal meningitis and cytomegalovirus infection, with an emphasis on clinical pearls, pathological findings, MRI findings and treatment. Moreover, we discuss the risk factors, pathophysiology and management of IRIS. We also summarize the challenges that remain in management of CNS opportunistic infections, which includes the lack of phase II and III clinical trials, absence of antimicrobials for infections such as PML, and controversy regarding the use of corticosteroids for treatment of IRIS.

Indexed as

AIDS-Related Opportunistic InfectionsCytomegalovirus InfectionsHIV InfectionsImmune Reconstitution Inflammatory SyndromeLeukoencephalopathy, Progressive MultifocalMeningitis, CryptococcalToxoplasmosis, CerebralTuberculosis, MeningealHumans

Identifiers

PMID27786246
OpenAlexW2546273436

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.