Title: Neurological Manifestations in the Patients with HIV/AIDS
Authors: Dr Murugesh Pastapur, Dr Maitrey Patel, Dr Rajiv S Konin
DOI: https://dx.doi.org/10.18535/jmscr/v4i12.128
Abstract
Background: HIV/ AIDS has posed many unprecedented challenges. It causes a wide spectrum of disease manifestations. Neurological diseases is the first manifestation of symptomatic HIV infection in roughly 10-20% of patients, while about 60% of patients with advanced HIV disease will have clinically evident neurological dysfunction during the course of their illness.
Objectives: To study the neurological manifestations in patients with HIV/AIDS admitted to MRMC, Gulbarga and to note differences with various other studies carried out in India and in western countries and to evaluate simpler and cost effective diagnostic techniques.
Methods: A total of 50 patients admitted in medicine wards in Basaveshwar Teaching & General Hospital attached to M.R. Medical College, Gulbarga during a study period between November 2009 and September 2011, who were found to have HIV infection and history suggestive of nervous system manifestations were enrolled in the study.
Results: Of the total 50 patients, 33 were males and 17 were females with M:F ratio of 1.95:1. 88% of patients were between age group of 18-45 years. Meningitis was the most common neurological presentation (58%), comprising 16 patients with tubercular meningitis (32%), 7 patients with cryptococcal meningitis (14%), 5 patients with aseptic meningitis (10%), and 1 patient with bacterial meningitis (2%).
Fever (66%), headache (64%), altered sensorium (38%) and convulsions (34%) were the commonest neurological symptoms. Tuberculosis was the commonest disease affecting CNS (38%), with 16 patients having meningitis (32%) and 3 patients having tuberculoma (6%). The most common space occupying lesions was toxoplasmosis (10%).
Conclusion: There is high incidence of neurological manifestations affecting mainly economically reproductive age group (18-45 years) with tuberculosis and cryptococci being the most commonest pathogenic agents in course of HIV infections in this study.
Keywords: Human immunodeficiency virus; Tubercular meningitis; Cryptococcus meningitis; Toxoplasmosis.
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