The Clinical Spectrum of Neurological Manifestations in HIV/AIDS Patients on HAART at the Lagos University Teaching Hospital, Lagos, Nigeria

Abstract

Background: The human immunodeficiency virus (HIV) is primarily neurotrophic and lymphotrophic. Diverse neurologic sequealae have been documented with variations based on disease severity, but geographic variation may determine the distribution of these neurological complications. Objective: This study was designed to evaluate the current status of neurologic manifestations of HIV/AIDS as seen at our tertiary referral centre in Lagos, Nigeria. Methods: Consecutively presenting persons with HIV/AIDS receiving HAART, who were seen between August 2004 and March 2006 at the Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, were recruited into the study. Results: Two hundred and fifty consecutively presenting HIV sero-positive patients were seen. There were 102 males (40.8%) and 148 females (59.2%) with a mean age of 37.4 years. 86 (34.4%) had clinically evident neurological disease, including neurocognitive dysfunction in 65 (53%), distal sensory neuropathy in 41(16.4%), meningitis in 16 (6.4%), myopathy in 13 (5.2%), myelopathy in 6 (2.4%) and cerebrovascular disease in 5 (2%). The mean CD4 count (cells/mm3) of patients with neurological disease, 201.1±124.8 was significantly lower than that of patients without neurological disease 253.5±149.2 (P=0.001). Conclusion: Clinically evident neurological disease occurs in about 1/3rd of patients with HIV/AIDS on HAART at our tertiary centre, and predominantly affects patients with more advanced disease stages evidenced by lower CD4 count.

Key words: Neurology, HIV, AIDS, cognitive dysfunction