Neurological Manifestations Hiv-Infected Patients Around Varanasi, India

Abstract

Background Most of the studies on the neurological manifestations in HIV patients in India were cross sectional in design, and focus on the etiological agents. We report data on the frequency of neurological manifestations, associations with CD4 counts, and outcome of its various presentations in a 3-year prospective hospital-based study.

Methods
All HIV-infected patients attending the Infectious Disease clinic for various neurological manifestations between Jan 2001 and December 2003 were included in the study. Their clinical details, treatment received, and response to treatment were accessed and analyzed.

Results
During this period, 57 had some neurological manifestations and made 145 clinic visits, with 158 distinct episodes of neurological related symptoms, giving a crude rate of 307 neurological episodes per 1000 person year of observation

Conclusion
Opportunistic infections were the leading cause of neurological disorders in our study population. Apart from Central nervous system (CNS) tuberculosis, other CNS diseases were good predictor of the advanced HIV infection (CD4<200). CNS tuberculosis cannot be considered as an opportunistic infection in most of the instances as it can be seen in relatively earlier stages of the disease. Cerebrospinal fluid picture was normal in all our patients of CNS toxoplasmosis. All the patients with progressive multifocal leuco encephalopathy had seizures as the initial manifestation. AIDS-dementia complex and CNS malignancies were not observed in our patients. There were equal responses to Amphoterecin B Cholesterol Dispersion (ABCD) and conventional Amphoterecin B therapies, and no significant differences in their side effect profiles.


Keywords: infections, HIV, India

African Journal of Neurological Sciences Vol. 25 (1) 2006: pp. 33-40