Seizures in HIV/AIDS: a southern African perspective

Bhigjee, Ahmed Iqbal

doi:10.1111/j.1600-0404.2005.00500.x

Cited by 9 publications

(9 citation statements)

References 14 publications

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“…The central and peripheral nervous system seems to be the site of predilection for the Human Immunodeficiency Virus (HIV). In fact Ogun [1] in a Nigerian study estimated that 45.5% of patients infected with HIV develop neuronlogical complications and Bhigjee [2] in South Africa estimated a rate of 70%. The neurological complications could be due to the HIV itself, to opportunistic infections or a central nervous system (CNS) lymphoma [3].…”

Section: Introductionmentioning

confidence: 99%

“…Patients infected with HIV usually develop neurological complications like: cerebral toxoplasmosis, tuberculous meningo-enkephalitis, cryptococcal meningitis, cytomegalovirus infection, lymphomas, dementia, myelopathies and polyneuropathies etc. Seizures are frequently a common clinical manifestation of these pathologies: 3% in Spain [4], 5% in India [5], 11% in the USA [6], 3% to 17% in South Africa [2]. Bartholomei et al [7] in France discovered that 33% of patients infected by the HIV present with epileptic crisis as inaugural neurological manifestation.…”

Section: Introductionmentioning

confidence: 99%

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Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the Yaounde Central Hospital (Cameroon)

Mbonda¹,

Kuate²,

Njamnshi³

et al. 2013

WJA

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Introduction: Patients infected with HIV usually develop neurological complications. Seizures are amongst clinical manifestation of these neurological complications of HIV infection. We report on 150 HIV positive patients who presented with newly onset seizures. Objectives: Our objective was to evaluate the influence of HIV infection on epilepsy and particularly to look for the most common epilepsy induced complications in our context. Methodology: We recruited all patients infected with HIV and who consulted at the outpatient or admitted in the in the neurology unit of the Yaounde Central Hospital, for seizures from August 1st 2008 to December 31st 2009. All the patients were aged above 18 years, black and of Cameroonian nationality. All those who had a family history of epilepsy, as well as those with a personal history of epilepsy were excluded from the study. Results: During the period of study, we recruited 150 patients aged 38.7 ± 9.9 years and with an M/F sex ratio of 0.76. Generalized seizures were observed in 66% of patients, of whom 58% were HIV 1 positive and an average CD4 count of 65.4 ± 11.7/μl. Cerebral toxoplasmosis was the most common etiology observed in 30% of cases. Discussion: This study being hospital based must have selected the most serious patient with severe immunodeficiency. This can explain why a precise etiology was found in the majority of cases. Modi et al. (1999) found a space occupying lesion in 53%, meningitis in 22% and 25% without identifiable etiology in black South Africans. Central nervous system tuberculosis was the most frequent cause encountered in 64% of patients with etiologies. Conclusion: Seizures are one of the principal manifestations of HIV infection or its complications. Their prevalence is 9.5% in our study. Cerebral toxoplasmosis is the most frequent etiology in our study, followed by cryptococcal meningitis and tuberculous meningitis.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the Yaounde Central Hospital (Cameroon)

Mbonda¹,

Kuate²,

Njamnshi³

et al. 2013

WJA

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“…HIV is associated with neuron injury and encephalopathy with cognitive, motor, and behavioral dysfunction. [19][20][21] In addition, there are the HIV-associated opportunistic infections (eg, tuberculous meningitis and toxoplasmosis) 20,22 and drug treatment-related toxicities. Stroke, most often associated with sickle cell anemia and HIV, is a prominent cause of disability in the older child.…”

Section: Causes Of Neurological Disordersmentioning

confidence: 99%

Child Neurology Practice and Neurological Disorders in East Africa

et al. 2010

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Neurological disorders, including neurodevelopmental disorders, have been identified by the World Health Organization (WHO) as one of the greatest threats to global public health. It is generally believed that these conditions are more prevalent in the developing than the developed world because of multiple known risk factors such as infections, malnutrition, and limited resources for obstetric and neonatal management. In East Africa, few investigations have been conducted to obtain data on the magnitude and description of neurological disorders among children, and the practice of child neurology is faced with challenges cutting across areas of health personnel, patient diagnosis, management, and rehabilitation. This article reviews the burden, types, and causes of neurological disorders in the East African region. The challenges and successes in the practice of child neurology and recommendations for the future are discussed.

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“…The prevalence of seizures in children with confirmed HIV infection has been reported to range from 2% to 14%, 9 , 15 , 16 , 17 , 18 and the prevalence of epilepsy is estimated between 0.29% and 11.3%. 19 , 20 , 21 This wide variation is believed to be a result of differences of risk factors in different regions.…”

Section: Introductionmentioning

confidence: 99%

Late diagnosis of human immunodeficiency virus infection is linked to higher rates of epilepsy in children in the Eastern Cape of South Africa

Michaelis

Nielsen

Carty

et al. 2020

Southern African Journal of HIV Medicine

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Background: Human immunodeficiency virus (HIV)-positive children may present with a wide range of neurological disorders. Among these, epilepsy is of key concern because of its lifelong impact and potential for damage to the central nervous system (CNS). Few studies in developing regions have investigated the prevalence and aetiology of epilepsy in HIV-infected children as a key population.Objectives: We describe the prevalence of epilepsy, associated neurological disabilities, immunological status, clinical stage and history of CNS infection at epilepsy diagnosis in a cohort of HIV-infected children receiving antiretroviral therapy (ART) in the Eastern Cape of South Africa.Methods: We conducted a retrospective study (2004–2014) at two major referral sites for HIV-infected children diagnosed with epilepsy aged 0–16 years. Eligible subjects were extracted from the electronic medicine bridging access to care in excellence (EMBRACE) Paediatric Cohort using the Paediatric ART Data Management Tool (PADMT). Fixed data fields were interrogated for exposures to antiepileptic drugs. Unstructured ‘comments’ fields were searched for the terms: epilepsy, seizures, fits and szs, as well as abbreviated versions of common antiepileptic drug names. Eligible subject folders were then retrieved to validate the digital data.Results: From 2139 children enrolled in the two sites, 53 children were diagnosed with epilepsy (2.48%). In these, the median CD4 count was 591 cells/mm3, and the mean viral load was 4.9 log copies/mL, with undetectable viral loads in only seven children (14.0%). World Health Organization (WHO) clinical HIV stage was available for 46 patients of the sample, with 3, 6, 26 and 11 children graded at stages 1, 2, 3 and 4, respectively. Forty percent children had a history of CNS infection prior to the epilepsy diagnosis, and 55% children were reported to have school problems.Conclusions: In this descriptive study, the prevalence of epilepsy among children with HIV was 2.48%, mostly diagnosed in advanced HIV-disease stages. Our findings support the usefulness of early detection and initiation of ART in HIV-infected children in order to reduce the risk of epilepsy. In addition, our study demonstrates that novel techniques are effective in accessing cohort-level data that allow interrogation of both structured and unstructured clinical data.

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Seizures in HIV/AIDS: a southern African perspective

Cited by 9 publications

References 14 publications

Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the Yaounde Central Hospital (Cameroon)

Etiologic Aspects of Epileptic Seizures of Recent Onset in HIV-AIDS Infected Subjects at the Yaounde Central Hospital (Cameroon)

Child Neurology Practice and Neurological Disorders in East Africa

Late diagnosis of human immunodeficiency virus infection is linked to higher rates of epilepsy in children in the Eastern Cape of South Africa

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