Title: A Study of Neurological Manifestations of HIV in a Tertiary Care Centre
Authors: Dr T L Narayana Geetha, Dr Azma Naaz, Dr. Y G Sundara Raju
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.139
Abstract
Introduction: Neurological manifestations of HIV consists of CNS complications caused directly by HIV, and include cognitive disorders and other CNS disease such as myelopathy and the demyelinating neuropathies and the secondary disorders caused by opportunistic infections, neoplasm, cerebrovascular events, as also the effects of metabolic derangements and medications.
Aims And Objectives
- To study the spectrum of neurological manifestations in HIV infected subjects.
- To study the correlation of neurological manifestations with CD4
Materials and Methods: This is a cross sectional study conducted in 100 HIV patients admitted in King George Hospital, in whom a detailed history and clinical evaluation done, after an informed consent from the patient or relative.
Study Period: October2017 to September 2019
Inclusion Criteria: All HIV Patients admitted at king George hospital in medical and neurology wards
Exclusion Criteria: Immuno Compromised state due to any other cause.
Results: The following were the details of neurological manifestations. Tuberculous meningitis (35.4%), cerebrovascular complications (9.67%), Guillian barre syndrome (3.22%), pyogenic meningitis (6.44%), peripheral neuropathy (6.44%), seizure disorders (6.44%), acute flaccid paralysis (3.22%), AIDS dementia complex (3.22%), cerebellar syndrome (3.22%), cryptococcal meningitis (3.22%),Toxoplasmosis (3.22%), HIV myelopathy (3.22%), Tuberculoma (3.22%). Mortality increased most with coexisting meningitis and with decreased CD4 counts. Commonest neurological condition associated was neurotuberculosis.
Conclusions: Incidence of neurological illness in HIV infection in our study was 31%.All patients in our study had heterosexual transmission of disease..Headache and altered mentation were the two common symptoms observed in this study. Tuberculous meningitis was the most commonest opportunistic infection in our study. No significant CD4 count correlation was found between the patients with neurological manifestations. CD4 count when less was associated with increased mortality. Patients with coexisting tuberculous meningitis and HIV infection had significantly lower CD4 counts.
References
- I. Bhigjee MD, S. Madurai Msc, P.L.A.Bill FRCP, et al. Spectrum of myelopathies in HIV seropositive South African patients. Neurology 2001;57:348-351.
- Mamidi A. Central Nervous system infections in individuals with HIV-1 infection. J. Neurovirol. 2002 Jun:8(3) : 158-67.
- Bandyopadhyay D, Sarkar RN, Mandal SK, Bandyopadhyay R. Neurological manifestations of HIV/AIDS. JAPI 2005;53:379.
- Vijay Teja, Vidhya Gulkarni. Spectrum of Neurological Manifestations of HIV/AIDS. Journal of Neurology 2005
- Sokolska V. The Role of brain magnetic resonance studies in the diagnostics of central nervous system lesions in HIV – 1 positive patients. Wiad Lek. 2006:59(11-12) : 805-13 : Polish
- Offiah CE. The imaging appearances of intracranial CNS infections in adult HIV and AIDS patentis. Clin Radiol. 2006 May; 61(5) : 393-401.
- Goodkin K, Wilkie FL. Aging and neuro-AIDS conditions and the changing spectrum of HIV-1-associated morbidity and mortality. J Clin Epidemiol. 2001.
- Levy RM, Bredesen DE. Central Nervous System dysfunction in acquired immunodeficiency syndrome. J Acquir Immune Defic Syndr. 1998 ; 1(1) : 41-64.
- Peters M. Meningovascular neurosyphilis in human immunodeficiency virus infection as a differential diagnosis of focal CNS lesions : a clinicopathological study. J Infect. 1993 Jul; 27(1) : 57-62.
- The neuropathology and epidemiology of AIDS. A Berlin experience. A review of 200 cases. Pathol Res Pract. 1995 Jun; 191(5) : 427-43.