A study of neurological problems in HIV infection
DOI:
https://doi.org/10.18203/2349-3933.ijam20201620Keywords:
Cryptococcal meningitis, CSF, HIV infection, Neurological problemsAbstract
Background: Knowledge of central nervous system manifestation (CS) is crucial for clinical practitioners, which is why this study was conducted to identify the neurological manifestations in HIV patient is crucial problems with HIV and the difficulties in managing these patients.
Methods: The present study was conducted on patients of HIV infection who were either admitted or being treated in OPD during study period. The cases were selected based seropositivity for HIV on two consecutive occasions by ELISA and presence of WHO surveillance definition criteria. Based on a detailed history account including high risk behaviour to HIV infection was obtained from patients or relatives. Then each patient was subjected to thorough physical examination with specific attention to any clinical evidence of immunosuppression viz oral thrush. Thorough neurological examination was done to localize the part of central nervous system affected. Patients were then categorized into various clinical neurological syndromes.
Results: Commonest finding was single or multiple ring enhancing lesions seen in 21(35%) patients followed by basal exudates (21.6%). Hydrocephalus was seen in 5 patients (8.3%) and infarct due to vascular lesion in 4(7%) patients. Oral thrush was more commonly seen in patients with cryptococcal meningitis. CSF analysis was useful and revealed abnormalities in most of the patients with infective disorders.
Conclusions: In conclusion, variety of neurologic manifestations occur and any part of nervous system can be affected in HIV infection and high index of euspicion is required to pick up the cases early in the course which may help to improve the quality and life span of these suspicion patients.
References
Singer EJ, Valdes-Sueiras M, Commins D, Levine A. Neurologic presentations of AIDS. Neurolog Clini. 2010 Feb 1;28(1):253-75.
Patrick MK, Johnston JB, Power C. Lentiviral neuropathogenesis: comparative neuroinvasion, neurotropism, neurovirulence, and host neurosusceptibility. J Virol. 2002 Aug 15;76(16):7923-31.
Patil HV. Neurological manifestations of HIV-AIDS at a tertiary care center in western Maharashtra. International Journal of Medicine and Public Health. 2014;4(3):210-7.
Rewari BB, Joshi PL. Epidemiology of HIV/AIDS with special reference to India. Chapter. 2003;3:77-86.
Maschke M, Kastrup O, Esser S, Ross B, Hengge U, Hufnagel A. Incidence and prevalence of neurological disorders associated with HIV since the introduction of highly active antiretroviral therapy (HAART). Journal of Neurology, Neurosurgery & Psychiatry. 2000 Sep 1;69(3):376-80.
Gray F, Chrétien F, Vallat-Decouvelaere AV, Scaravilli F. The changing pattern of HIV neuropathology in the HAART era. Journal of Neuropathology & Experimental Neurology. 2003 May 1;62(5):429-40.
Antinori A, Larussa D, Cingolani A, Lorenzini P, Bossolasco S, Finazzi MG, Bongiovanni M, Guaraldi G, Grisetti S, Vigo B, Gigli B. Prevalence, associated factors, and prognostic determinants of AIDS-related toxoplasmic encephalitis in the era of advanced highly active antiretroviral therapy. Clinical infectious diseases. 2004 Dec 1;39(11):1681-91.
Tan IL, Smith BR, von Geldern G, Mateen FJ, McArthur JC. HIV-associated opportunistic infections of the CNS. The Lancet Neurology. 2012 Jul 1;11(7):605-17.
UK Collaborative HIV Cohort (CHIC) Study Steering Committee. HIV‐associated central nervous system diseases in the recent combination antiretroviral therapy era. European journal of neurology. 2011 Mar;18(3):527-34.
McArthur JC. Neurologic manifestations of AIDS. Medicine. 1987 Nov;66(6):407-37.
Snider WD, Simpson DM, Nielsen S, Gold WJ, Metroka CE, Posner JB. Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 1983 Oct;14(4):403-18.
Levy RM, Bredesen DE, Rosenblum ML. Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. Journal of neurosurgery. 1985 Apr 1;62(4):475-95.
Levy RM, Bredesen DE, Rosenblum ML. Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. Journal of neurosurgery. 1985 Apr 1;62(4):475-95.
Lanjewar DN, Jain PP, Shetty CR. Profile of central nervous system pathology in patients with AIDS: an autopsy study from India. Aids. 1998 Feb 12;12(3):309-13.
Gupte SS, Joshi SR, Lanjewar DN, Kaur B. Neurological manifestations of HIV-1 infection and AIDS. CARC calling. 1993 Jun;6:30-4.
Wong MC, Labar DR. Seizures in human immunodeficiency virus infection. Archives of neurology. 1990 Jun 1;47(6):640-2.
Holtzman DM, Kaku DA, So YT. New-onset seizures associated with human immunodeficiency virus infection: causation and clinical features in 100 cases. The American journal of medicine. 1989 Aug 1;87(2):173-7.
Petty RK. Recent advances in the neurology of HIV infection. Postgraduate medical journal. 1994 Jun;70(824):393.
