Background: The nervous system is among the most frequent and serious target of HIV infection, occurring in patients with profound immunosuppression even some time neurological disease is the first manifestation of symptomatic HIV infection in 10-20% of patients. Aims & Objective: (1) To study the clinical, investigation profile and various neurological disorders in HIV positive patients; (2) To correlate neurological manifestations in HIV patients with CD4 Counts. Materials and Methods: 40 HIV positive patients with neurological manifestations were enrolled. Apart from routine investigations, CD4 cell count, MRI brain, CSF, electromyography and nerve conduction study were done whereas required. Results: Meningitis was the commonest diagnosis (52.5%) followed Peripheral neuropathy (20%). Cerebrovascular accident was present in 3 cases. Intracranial space occupying lesion was found in 3 cases. Headache was the commonest neurological symptom seen in 25(62.5%) patients. Altered sensorium was found in 55%. Cranial nerve involvement was seen in 7 (17.5%) patients. Convulsion was reported in 10 (25 %) of the patients. Choreoathetoid movement was present in one patient. CD4 Count was done in 37 patients. In 13 patients it was between 200-500/µl & <200/µl in 24 Patients. CD4 count was <200/ µl in most of the patients having TBM (73%), < 200/ µl in 75% of cryptococcal meningitis. Conclusion: Most of the neurological sign symptoms are due to secondary causes which vary according to the geographical areas. So the knowledge of epidemiology of neurological presentation may help in early diagnosis and treatment of patients.

Abstract:In this review, immune response and possible causes of depletion of CD4