The Clinical Spectrum of Neurological Manifestations in AIDS Patients in Mexico

Góngora‐Rivera, Fernando; Santos-Zambrano, J; Moreno-Andrade, Talía; Calzada-López, Paloma; Soto-Hernández, José Luís

doi:10.1016/s0188-4409(00)00067-9

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…However, the incidence of PML has decreased less dramatically when compared to other CNS diseases in the HAART era 6,21 . Interestingly, PML has rarely been reported in HIV-infected patients from developing countries 8,11,12 . The objectives of this study were to describe the clinical and radiological features of patients with PML and estimate its frequency among AIDS patients with CNS opportunistic diseases admitted in a referral center in Brazil.…”

Section: Introductionmentioning

confidence: 99%

Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil

Vidal

Oliveira

Fink

et al. 2008

Rev. Inst. Med. trop. S. Paulo

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SUMMARYFew data are available about progressive multifocal leukoencephalopathy (PML) in patients with acquired immunodeficiency syndrome (AIDS) from Brazil. The objectives of this study were to describe the main features of patients with PML and estimate its frequency among AIDS patients with central nervous system (CNS) opportunistic diseases admitted to the Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, from April 2003 to April 2004. A retrospective and descriptive study was performed. Twelve (6%) cases of PML were identified among 219 patients with neurological diseases. The median age of patients with PML was 36 years and nine (75%) were men. Nine (75%) patients were not on antiretroviral therapy at admission. The most common clinical manifestations were: focal weakness (75%), speech disturbances (58%), visual disturbances (42%), cognitive dysfunction (42%), and impaired coordination (42%). The median CD4+ T-cell count was 45 cells/µL. Eight (67%) of 12 patients were laboratoryconfirmed with PML and four (33%) were possible cases. Eleven (92%) presented classic PML and only one case had immune reconstitution inflammatory syndrome (IRIS)-related PML. In four (33%) patients, PML was the first AIDS-defining illness. During hospitalization, three patients (25%) died as a result of nosocomial pneumonia and nine (75%) were discharged to home. Cases of PML were only exceeded by cases of cerebral toxoplasmosis, cryptococcal meningoencephalitis, and CNS tuberculosis, the three more frequent neurologic opportunistic infections in Brazil. The results of this study suggest that PML is not an uncommon HIV-related neurologic disorder in a referral center in Brazil.

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Section: Introductionmentioning

confidence: 99%

Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil

Vidal

Oliveira

Fink

et al. 2008

Rev. Inst. Med. trop. S. Paulo

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“…Roughly 40 to 60% of patients with AIDS will develop neurological sequelae at some stage of the disease [1020]. Additionally, an autopsy review found that up to 80% of AIDS patients had evidence of neurological pathology [2122]. Neurotrophic opportunistic infections like toxoplasmosis and cryptococcal meningitis can develop in the immunocompromised state.…”

Section: Discussionmentioning

confidence: 99%

Impact of Human Immunodeficiency Virus in the Pathogenesis and Outcome of Patients with Glioblastoma Multiforme

Choy

Lagman

Lee

et al. 2016

Brain Tumor Res Treat

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BackgroundImprovement in antiviral therapies have been accompanied by an increased frequency of non-Acquired Immune Deficiency Syndrome (AIDS) defining malignancies, such as glioblastoma multiforme. Here, we investigated all reported cases of human immunodeficiency virus (HIV)-positive patients with glioblastoma and evaluated their clinical outcomes. A comprehensive review of the molecular pathogenetic mechanisms underlying glioblastoma development in the setting of HIV/AIDS is provided.MethodsWe performed a PubMed search using keywords “HIV glioma” AND “glioblastoma,” and “AIDS glioma” AND “glioblastoma.” Case reports and series describing HIV-positive patients with glioblastoma (histologically-proven World Health Organization grade IV astrocytoma) and reporting on HAART treatment status, clinical follow-up, and overall survival (OS), were included for the purposes of quantitative synthesis. Patients without clinical follow-up data or OS were excluded. Remaining articles were assessed for data extraction eligibility.ResultsA total of 17 patients met our inclusion criteria. Of these patients, 14 (82.4%) were male and 3 (17.6%) were female, with a mean age of 39.5±9.2 years (range 19–60 years). Average CD4 count at diagnosis of glioblastoma was 358.9±193.4 cells/mm3. Tumor progression rather than AIDS-associated complications dictated patient survival. There was a trend towards increased median survival with HAART treatment (12.0 vs 7.5 months, p=0.10)ConclusionOur data suggests that HAART is associated with improved survival in patients with HIV-associated glioblastoma, although the precise mechanisms underlying this improvement remain unclear.

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“…Gongora Rivera F et al in their study found 89.3% males and 10.7% female patients. [3] Attili Venkata Satya et al found that males were higher in number than females. [4] Mean age of all patients was 35.24 years.…”

Section: Discussionmentioning

confidence: 99%

Central Nervous System Infections in HIV Patients: An Experience from a Tertiary Level Hospital in Mumbai

Pednekar¹,

James²,

Lachuria³

2016

AIMDR

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Background: Opportunistic infections of the central nervous system (CNS) are common complications of advanced immunodeficiency in individuals with human immunodeficiency virus (HIV) infection. We aimed to study the clinical profile of CNS infections in HIV patients, effect of antiretroviral therapy (ART) on various patient variables and mortality outcomes associated with various patient characteristics. Methods: After approval of the ethics committee, we enrolled 100 patients from the Department of Medicine at Lokmanya Tilak Municipal General Hospital from January 2011. Patients who were diagnosed with HIV using ELISA and admitted with a CMS infection were consented and enrolled for the study. Various clinico-laboratory parameters like CD4 counts, ART, signs and symptoms were collected and analysed with approapriate statistical techniques. P vlaue less than 0.05 was taken as staistically significant. Results: Out of 100 patients, 71 were males, average age 35.24 years. Majority had headaches, CD4 counts between 101-200 cells/mm3and 57 were on ART. Tubercular mengitis was the most common CNS infection in our patient population. We found statistical signifiance in the occurance of CNS infections and ART among patients. Mortality outcomes were significantly associated with signs and symptoms of the patients (p < 0.05). Conclusion: Our results show that CNS infections can occur even with high CD4 counts. So strict monitoring and long term followup of HIV patients is needed. Areas of future research should focus on long term clinical outcomes of HIV patients and elucidating factors reponsible for it.

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The Clinical Spectrum of Neurological Manifestations in AIDS Patients in Mexico

Cited by 17 publications

References 14 publications

Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil

Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil

Impact of Human Immunodeficiency Virus in the Pathogenesis and Outcome of Patients with Glioblastoma Multiforme

Central Nervous System Infections in HIV Patients: An Experience from a Tertiary Level Hospital in Mumbai

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