White matter changes in HIV have overlapping appearances and varied in etiology.
These can be divided into:
primary effects of HIV
neoplasms
vascular disease
metabolic and nutritional disorders
unknown mechanism
Primary effects of HIV
Opportunistic infection
cytomegalovirus (CMV) encephalitis (can also cause ventriculitis)
other viral encephalitides
toxoplasmosis encephalitis (can also cause abscesses)
Neoplasms
Vascular disease
-
HIV associated cerebral vasculopathy 2
appears similar to cerebral vasculitis, but without the histopathological changes
leucoclastic vasculitis of the vasa vasorum identified
may affect large, medium and small vessels
may respond to ART
Metabolic and nutritional disorders
-
high T2 signal usually does not affect white matter