Monna Mohamed Jaber, P (2012) A Study on Neurological Manifestations in HIV Patients. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
CONTEXT: HIV is a neurotropic virus. In a resource-limited country such as India, large populations of affected patients now have access to adequate Chemoprophylaxis for opportunistic infections ,allowing them to live longer. Unfortunately the poor availability of highly active antiretroviral therapy has allowed viral replication to proceed unchecked. This has resulted in an increase in the debilitating neurologic manifestations due to HIV. OBJECTIVES: This study was under taken to study the diverse clinical presentations of neurologic abnormalities in HIV patients admitted in CMCH, and their association with CD4 counts at the time of presentation ,and to compare the differences in the Neurological manifestations of HIV infection in patients in this study with the various studies carried out in western countries and north India . DESIGN AND SETTINGS: All HIV-infected patients who was admitted in medicine, neurology and skin and STD wards CMC Hospital between October 2010 and September 2011 were subjected to thorough neurological evaluation and those with symptoms referring to neurological illness were enrolled in this study Hospitalised patients with neurological signs and symptoms who were screened based on clinical clues and confirmed to have HIV-1 and/or HIV-2 infection were also enrolled. RESULTS: 71 of the 171 HIV positive patients fulfilled the inclusion criteria and were studied for neurological manifestations (41.7 %). Patients age ranged from 18 years to 48 years with male: female ratio of 2.94:1. 92.95 % of the patients were between age group of 20-45 years. 60.56 % were presenting with neurological symptoms and signs for the first time and were diagnosed HIV positive following admission. Meningitis was the commonest presentation (57.7%), Tuberculosis is the single most common organism affecting CNS (42.2%) fallowed by cryptococcal meningitis. Headache, fever and altered sensorium were commonest symptoms in HIV patients with Neurological pathology. 87.3% of the patients with neurological symptoms had CD4 count less than 200.Tubercular involvement in form of meningitis (26.76 %) and intracranial space occupying lesion (Tuberculoma) in 11patients (15.49 %) was the single largest etiological agent. Anti Toxoplasma antibodies. In two patients with multiple mass lesions on cranial CT, anti-Toxoplasma antibody was positive. Non Opportunistic manifestations in our study include peripheral neuropathy (5.63%), Stroke syndromes(9.86%), HAND (2.81%), and one case of PML (1.4%). CNS Lymphoma was not observed in any of our patients. INTERPRETATION AND CONCLUSION: Opportunistic infections are the leading cause of neurological disorders in our study population with Neurotuberculosis the commonest disease affecting nervous system fallowed by Cryptococcal infection. There is a significant correlation between the levels of CD4 counts and the type of neurological manifestations of HIV infection.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.20091218 |
| Uncontrolled Keywords: | Human Immunodeficiency Virus, CD 4 cell count; Tubercular meningitis, Cryptococcal meningitis, HIV associated neurocognitive disorders(HAND), Progressive Multifocal Leukoencephalopathy. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Sep 2020 16:49 |
| Last Modified: | 12 Sep 2020 16:49 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13114 |
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