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The central nervous system (CNS) is among the most frequent and main target of HIV infection in severely immunocompromised patients. Neurological m anifestations occur due to either primary pathologic process of HIV or secondary to opportuni stic infection. The present study was conducted to ascertain the prevalence of various neurological ma nifestations in HIV positive patients, correlation of CD4 levels in CNS opportunistic infection and their ou tcome. This was a prospective observational study of 105 HIV infected patients with clinical ev idence of CNS involvement. A detailed clinical hist ory and CNS examination was carried out. CD 4 counts was measured by flow cytometry method and o ther investigations like magnetic resonance imaging (MRI ), brain/electromyography, nerve conduction studies and cerebrospinal fluid (CSF) examination w ere done as required for diagnosis. HIV induced primary illness was present in about 30% cases whil e 70% associated with secondary CNS manifestations were mainly due to opportunistic inf ection. The most common primary illness was distal symmetrical polyneuropathy (20.9%), followed by AID S dementia complex (3.8%), acute inflammatory demyelinating neuropathy (3.8%). On the other hand, the most common secondary CNS infection was tuberculous bacterial (TBM; 32.3%), followed by cry ptococcal meningitis (13.3%), progressive multifoca l leukoencephalopathy (PML; 11.4%), and cerebral toxo plasmosis (9.5%). The commonest presenting symptoms of TBM were fever (72.38%), while headache and vomiting was 27.62 and 28.57%, respectively. Mean CD 4 count was 172 ± 81.2 in distal symmetrical polyneu ropathy (DSPN), 282 ± 75.3 in acute inflammatory demyelinating neuropathy (AIDP) and 95 ± 6.5 for AIDS dementia complex.

journal of aids and hiv research

Various neurological manifestations in HIV positive patients, their outcome and its correlation with CD4 counts- A tertiary centre experience in North Indian population