Neurological complications in late-stage hospitalized patients with HIV disease
Background and Objective: The nervous system is the most frequent and serious targets of human immunodeficiency virus (HIV) infection. In spite of a wide prevalence of neurological manifestations in HIV there are not many studies to look into it, especially from this part of the world. We investigat...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2011-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2011;volume=14;issue=3;spage=172;epage=177;aulast=Singh |
| _version_ | 1811237435898593280 |
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| author | Rakendra Singh Manjot Kaur Deepak Arora |
| author_facet | Rakendra Singh Manjot Kaur Deepak Arora |
| author_sort | Rakendra Singh |
| collection | DOAJ |
| description | Background and Objective: The nervous system is the most frequent and serious targets of human immunodeficiency virus (HIV) infection. In spite of a wide prevalence of neurological manifestations in HIV there are not many studies to look into it, especially from this part of the world. We investigated various neurological manifestations of HIV and their association with CD4 and CD8 counts at the time of presentation. Materials and Methods: All HIV-infected patients who presented to 750 bedded teaching hospital in North India were subjected to thorough neurological and neuropsychological evaluation. Wherever indicated, neuroimaging, cerebrospinal fluid study, electromyography, and nerve-conduction studies were performed to confirm the diagnosis. CD4 and CD8 counts were calculated. Results: A total of 416 HIV-positive patients were seen. Of them 269 were males. A total of 312 neurological events were identified in 268 patients having evidence of neurological involvement. HIV-associated dementia (HAD) was the most common cause of morbidity (33.65%), followed by CNS infections (21.63%). Most common CNS infection was tuberculosis (65.56%). CD4 counts in CNS infections and HAD were 64.8/ml and 83.52/ml, respectively. Most of the patients in our study had low scores on MMSE (22.32). Conclusions: Even in the absence of overt neurological disease, subclinical involvement in the form of subtle cognitive and motor decline is found to occur with greater frequency. Most of these patients have lower CD4 and CD8 counts, thus substantiating the proposition that neuroAIDS is a late manifestation. Significant correlation exists between CD4 counts and type of neurological manifestation. We concluded that neuropsychological assessment should be mandatory for all HIV-positive patients. |
| first_indexed | 2024-04-12T12:23:57Z |
| format | Article |
| id | doaj.art-1d2c3b4bb52f41cd8c56d734aeba8272 |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-04-12T12:23:57Z |
| publishDate | 2011-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-1d2c3b4bb52f41cd8c56d734aeba82722022-12-22T03:33:13ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492011-01-0114317217710.4103/0972-2327.85878Neurological complications in late-stage hospitalized patients with HIV diseaseRakendra SinghManjot KaurDeepak AroraBackground and Objective: The nervous system is the most frequent and serious targets of human immunodeficiency virus (HIV) infection. In spite of a wide prevalence of neurological manifestations in HIV there are not many studies to look into it, especially from this part of the world. We investigated various neurological manifestations of HIV and their association with CD4 and CD8 counts at the time of presentation. Materials and Methods: All HIV-infected patients who presented to 750 bedded teaching hospital in North India were subjected to thorough neurological and neuropsychological evaluation. Wherever indicated, neuroimaging, cerebrospinal fluid study, electromyography, and nerve-conduction studies were performed to confirm the diagnosis. CD4 and CD8 counts were calculated. Results: A total of 416 HIV-positive patients were seen. Of them 269 were males. A total of 312 neurological events were identified in 268 patients having evidence of neurological involvement. HIV-associated dementia (HAD) was the most common cause of morbidity (33.65%), followed by CNS infections (21.63%). Most common CNS infection was tuberculosis (65.56%). CD4 counts in CNS infections and HAD were 64.8/ml and 83.52/ml, respectively. Most of the patients in our study had low scores on MMSE (22.32). Conclusions: Even in the absence of overt neurological disease, subclinical involvement in the form of subtle cognitive and motor decline is found to occur with greater frequency. Most of these patients have lower CD4 and CD8 counts, thus substantiating the proposition that neuroAIDS is a late manifestation. Significant correlation exists between CD4 counts and type of neurological manifestation. We concluded that neuropsychological assessment should be mandatory for all HIV-positive patients.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2011;volume=14;issue=3;spage=172;epage=177;aulast=SinghCD4 and CD8 cell countsHIV-associated dementiaFolstein Mini Mental State Examinationneurological disordersneuro AIDS |
| spellingShingle | Rakendra Singh Manjot Kaur Deepak Arora Neurological complications in late-stage hospitalized patients with HIV disease Annals of Indian Academy of Neurology CD4 and CD8 cell counts HIV-associated dementia Folstein Mini Mental State Examination neurological disorders neuro AIDS |
| title | Neurological complications in late-stage hospitalized patients with HIV disease |
| title_full | Neurological complications in late-stage hospitalized patients with HIV disease |
| title_fullStr | Neurological complications in late-stage hospitalized patients with HIV disease |
| title_full_unstemmed | Neurological complications in late-stage hospitalized patients with HIV disease |
| title_short | Neurological complications in late-stage hospitalized patients with HIV disease |
| title_sort | neurological complications in late stage hospitalized patients with hiv disease |
| topic | CD4 and CD8 cell counts HIV-associated dementia Folstein Mini Mental State Examination neurological disorders neuro AIDS |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2011;volume=14;issue=3;spage=172;epage=177;aulast=Singh |
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