Study of Neurological and Biochemical Manifestations in HIV Patients

Abstract

Background & Aims: Nervous system involvement causes significant degree of morbidity in the patients with Human Immunodeficiency Virus (HIV) infection. At least 10% of the cases of Acquired Immune Deficiency Syndrome (AIDS) present with neurological symptoms and over the course of the illness symptomatic involvement of the central and peripheral nervous system has been found in 30 to 60% of the patients. Materials & Methods: This study included the patients with HIV disease presenting various neurological manifestations admitted into Departments of Medicine and Neurology. In all cases provisional diagnosis was made by taking detailed history and clinical examination. All the cases were subjected to investigations like CD4 count, CSF analysis, EEG, nerve conduction studies, and CT scan and MRI of brain and spinal cord to establish the etiology. Results: The predominant symptoms observed in the study were headache (70%) and fever (65%). Out of the 100 patients, 30 patients presented with seizures. Central nervous system tuberculosis is the underlying cause in 50% of the cases. Neck stiffness and positive kernig’s sign were seen in 55%. CSF analysis of the patients disclosed a picture suggestive of tuberculosis meningitis in 60%. The radiological evaluation in the form of CT or MRI brain showed lesions like cortical infarcts in 28%. Conclusion: The study disclosed tuberculosis of the CNS to be the major cause for seizures and other neurological disorders in HIV. Even though neurological manifestations can occur at any level of CD4 count, prognosis is bad if CD4 count is less than 200.

Keywords

• hiv
• cns manifestations
• csf analysis
• neuroimaging studies