AEGiS-15IAC: Pattern and outcome of Neurological manifestations of HIV/AIDS - a review of 154 cases in a Nigerian university teaching hospital.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Pattern and outcome of Neurological manifestations of HIV/AIDS - a review of 154 cases in a Nigerian university teaching hospital.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. B10083)

Ogun SA, Ojini FI, Okubadejo N, Danesi MA, Kolapo KO, Osalusi BS, Brian boyle B
Ogun state university teaching hospital Sagamu, Sagamu, Nigeria

BACKGROUND: The HIV is neurotropic and clinicians need to be aware of its myriad neurologic manifestations, as these may be the only clinical presentation. This retrospective study aims to evaluate the clinical spectrum and outcome of the neurologic manifestations in patients with HIV / AIDS over a ten year period.

METHODS: Records of Patients attending the HIV outpatient clinic of Olabisi Onabanjo University Teaching Hospital Sagamu; Nigeria, as well as those of medical in-patients with AIDS, were retrieved and reviewed from 1993 to 2003. The relevant information were obtained and Neurologic impairment related to HIV / AIDS as well as its sequelae within 6 months were recorded. Treatment was symptomatic in all patients and where appropriate, specific treatment was administered for indicator diseases. Highly Active Anti-retroviral Therapy (HAART) was not used routinely at the study centre.

RESULTS: A total of 362 patients with HIV / AIDS were reviewed over a ten-year period, of which 154 patients, (42.5%) had neurological manifestations. Forty-five (29%) patients had Herpes zooster, 40 (26%) had TB meningitis (TBM), 19 (12%) each had vacuolar myelopathy (VM) or AIDS dementia complex (ADC), 15 (9.7%) had toxoplasma encephalitis, 10 (6.5%) had painful acral dysaesthesia, 4 (2.6%) had mononeuritis multiplex, and 2 (1.3%) had subacute combined degeneration of the spinal cord. An overall 6-months mortality of 45% was recorded with ADC, VM and TBM as predictors of high mortality.

CONCLUSION: Herpes zooster appears to be the commonest neurological manifestation amongst HIV-infected patients while Tuberculous meningitis is the commonest AIDS defining illness. Our experience indicates that unusual neurological manifestations could be the first manifestation of HIV/AIDS, and there is need for awareness of these entities by practising doctors for prompt early diagnosis and treatment. Screening of all patients with Herpes zooster for HIV is also advised.

Keywords: AEGIS, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Hospitals, Teaching, Hospitals, University, Antiretroviral Therapy, Highly Active, AIDS Dementia Complex, Universities, Retrospective Studies, Nigeria, Humans, education

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B10083