Clinico-epidemiological profile of central nervous system manifestations in HIV patients (original) (raw)
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A study of clinical profile of HIV positive patients with neurological manifestations
HIV & AIDS Review, 2011
Background: Central nervous system (CNS) is among the most frequent and serious target of HIV infection in patients with profound immunosuppression. CNS problems occur mainly due to either primary pathologic process of HIV or secondary to opportunistic infection and neoplasm. Aims and objectives: To study the clinical and investigation profile in diagnosis of HIV patients with CNS manifestation. To correlate CD 4 levels with CNS opportunistic infections. Materials and methods: A prospective observational non-randomized clinical study of 50 HIV infected patients, showing clinical evidence of CNS involvement, admitted in tertiary care centre was done. Detail clinical history and CNS examination was carried out. CD 4 count was measured using standard flowcytometry. Investigations like MRI brain/electromyography-nerve conduction studies/cerebrospinal fluid (CSF) examination were done as and when required for diagnosis. Results: HIV induced primary CNS illness was present in 30% while 70% cases were due to secondary CNS manifestation mainly due to opportunistic infection. Most common primary illness was distal symmetric polyneuropathy (DSPN) (22%), followed by Aids dementia complex (ADC) (4%) and acute inflammatory demyelinating polyneuropathy (AIDP)(4%). tuberculous meningitis (TBM) was the most common presentation as secondary CNS illness (34%), followed by cryptococcal meningitis (14%), toxoplasmosis (10%), progressive multifocal leucoencephalopathy (PML) (8%) and neurosyphilis (4%). Meningitis was presenting CNS manifestation in majority of patients. The commonest presentation of TBM was fever (64%), while headache for cryptococcal meningitis (71%) and seizures was that of toxoplasmosis (80%). Mean CD 4 count was 170 ± 80.1 in patients of DSPN, 131 ± 85.75 for TBM, 47.5 ± 36.8 for cryptococcal, 160 ± 77.4 for toxoplasmosis and 93 ± 65 for ADC. Conclusion: High degree of clinical suspicion of nervous involvement in HIV patients at all stages help in early diagnosis and institution of specific therapeutic measures which in turn decrease mortality and morbidity.
DIFFERENTIAL DIAGNOSIS OF HIV POSITIVE PATIENTS WITH NEUROLOGICAL MANIFESTATIONS
National Journal of Medical Research, 2017
Introduction: The nervous system is among the most frequent and serious target of HIV infection and is most frequently occur in patient with profound immunosuppression. 40 to 70 percent persons with HIV have neurological disorder. In 10 to 20 percent it is AIDS defining illness. It has higher mortality than other infections. Considering these facts the current study was designed to check the differential diagnosis of various neurological manifestations in HIV patients. Methodology: All HIV positive patients above 18 years presenting with neurological manifestations and ready to give informed written consent to participate in the study were included in the study. Detailed clinical history with special emphasis on consciousness, convulsions and headache was taken. Thorough clinical examination included mental status examination including MMSE, sensory, motor and cranial nerves examination. Results: The present study comprises 50 HIV infected patients with neurological manifestation presenting at the hospital. There were total 15 (30%) patients diagnosed with primary neurological illness. Most of the patients were having DSPN as primary neurological illness. ADC is one of the common neurological manifestations. 4% of our patients had ADC which is diagnosed by MMSE (mini mental status examination) score. Out of total 50 patients, 35 (60%) patients were diagnosed as Secondary Neurological Illness. Out of these, TBM was the most common illness, Other common secondary illnesses were Cryptococcal Meningitis (16%), Toxoplasmosis (10%) and PML (8%). Conclusion: Tubercular Meningitis and Distal sensory polyneuropathy were the most common cause of neurological manifestation among HIV positive patients.
Assessment of neurological manifestations in HIV positive patients
INTERNATIONAL JOURNAL OF CURRENT RESEARCH IN BIOLOGY AND MEDICINE, 2017
Background: Nervous system involvement is one of the catastrophic target of human immunodeficiency virus (HIV) infection. Inspite of adequate ART (antiretroviral therapy), HIV infected individuals still experience neurological diseases. At least 40% HIV-infected patients devolp neurological symptoms during the course of their illness and in 10-20% of the patients, the presence of a neurological disease is the first manifestation of symptomatic HIV infection. Aims and Objectives: To illuminate the spectrum of neurological involvement in patients with HIV infection at Govt Medical College & Hospital Amritsar (Punjab). We evaluated various neurological manifestations of HIV including opportunistic infections (OPIs) and non-opportunistic infections (nonOPIs).
Healthcare
Background and Objectives: Central nervous system (CNS) disorders are estimated to occur in approximately 10–20% of people living with HIV (PLWH). They are more commonly observed in newly diagnosed patients and in previously untreated patients or those refusing to undergo antiretroviral treatment. CNS diseases can also be the first manifestation of HIV/AIDS infection. The most common HIV-related central nervous system diseases (CNS-D) are CNS toxoplasmosis, CNS cryptococcosis, progressive multifocal leukoencephalopathy (PML), and HIV-associated encephalopathy treated as a neurocognitive disorder. Materials and Methods: A retrospective analysis of available medical records was performed on 476 patients hospitalised over a period from 2016 to 2021 and diagnosed with HIV/AIDS infection at the department of infectious diseases at the Provincial Specialist Hospital in Wroclaw. An additional criterion for selecting patients for the analysis was the performance of head imaging using comput...
ARS Medica Tomitana
Abstract: This paper shows the results of a retrospective observational analytical study that has enrolled 166 HIV positive patients diagnosed with a neurological complication between June 2012 and June 2020, in Clinical Infectious Diseases Hospital of Constanta. 119 patients (71,69%) were diagnosed with one of the three neurological complications: HIV associated dementia (HAD), Progressive Multifocal Leukoencephalopathy (PML) and CNS Toxoplasmosis (CT). We have noted CD4 levels, viral loads, and the presence/absence of other infections like: HBV, HCV, Treponema pallidum, Mycobacterium Tuberculosis. The results show that PML and CT, in this order, are the main opportunistic infections with important neurological impact. Both, PML and CT are in direct correlation with the immune status, but also with other infections like the infection with HCV or with M. Tuberculosis. CD4 nadir <100 cells/mmc and viral load ≥100000copies/ml have a stronger association with PML (p<0,05). Patien...
Neurological Manifestations of HIV
Advances in HIV and AIDS Control, 2018
Neurological manifestations of human immunodeficiency virus (HIV) infection are common in certain regions of the world, notably Sub-Saharan Africa. The chapter highlights the neurotropism and neurovirulence of HIV underlying its direct neuropathology. The high frequency of neurological HIV disease is discussed in respect with the different viral clades. Sub-Saharan Africa is highlighted as bearing the brunt of the HIV pandemic. An approach to neurological HIV disease is given with a sensible classification system of manifestations and complications according to the level of immune suppression, primary HIV-related versus secondary opportunistic conditions, and other metabolic, drug induced, nutritional, or unrelated causes. Major manifestations of neuro-HIV are aseptic meningitis, HIV-associated neurocognitive disorders, HIV myelopathies and pediatric HIV-associated CNS disease; these are discussed in detail, and reference is made to the discrepancy of available data and literature between the so-called developed and developing countries. The role of antiretroviral treatment and its potential limitation in reaching the CNS compartment is stressed.
Neurological manifestations in HIV positive patients in Tehran, Iran
Asian Pacific Journal of Tropical Disease, 2014
To evaluate the neurological complications among Iranian HIV-positive patients. Methods: This cross-sectional study was conducted among 428 patients diagnosed with HIV infection between 2006 and 2009 at Imam Khomeini hospital, Tehran, Iran. Demographic and clinical variables as well as laboratory tests were extracted and analyzed. Also, another 100 patients refereed to Voluntary Counseling and Testing center of the hospital were visited and evaluated for neurological complications. Results: Among the patients, neurologic manifestations were observed in 34 (7.94%) patients. Twenty three percent of the patients received antiretroviral therapy. Identified causes included brain toxoplasmosis (14.7%), progressive multi-focal leuko encephalopathy (5.9%), HIV encephalopathy (5.9%), TB meningitis (5%) and unknown etiologies (11.8%). Also, among 100 patients who were admitted and visited at the Voluntary Counseling and Testing center, no one was diagnosed for any neurological manifestations. Conclusions: According to our results, toxoplasmosis is the most frequent cause of neurological conditions among Iranian HIV infected patients and should be considered in any HIV/AIDS patient with neurological manifestations. Contents lists available at ScienceDirect Peer reviewer D r. M a r y a m F o r o u g h i , I r a n i a n Research Center for HIV AIDS (IRCHA),