CD4 Count and Opportunistic Infections in HIV Positive Patients with Neurological Manifestations
Keywords:
TB Meningitis (TBM), CD4 count, HIV, Neurological ManifestationsAbstract
Introduction: CD4 count is having special predictive value in oc- currence of opportunistic infection. Opportunistic infection mostly occurs when CD4 count goes below 250 cells/microL.
Methodology: This was a cross sectional study, done in 50 HIV positive patients attending medicine OPD and admitted patients in SMIMER, a tertiary care hospital in Surat, Gujarat, India. All HIV positive patients above 18 years presenting with neurological manifestations and ready to give informed written consent to par- ticipate were included. Complete clinical assessment and laborato- ry investigations were performed in all cases.
Results: Mean CD-4 count in TBM was 140, in Cryptococcal men- ingitis was 52, in Toxoplasmosis was 170 and in AIDP was 281. The difference in the mean CD4 count is statistically significant (p- Value<0.001). Thus AIDP can occur at CD4 level as high as 281 cells/microL.
Conclusion: Most common primary neurological illness was DSPN and secondary neurological illness was TBM. AIDP can oc- cur at CD4 level as high as 281 cells/microL. Whereas other OIs can occur after CD4 count goes below 200 cells/microL.
References
HIV/AIDS in India. Available on: http://www.worldbank. org/en/news/feature/2012/07/10/hiv-aids-india. Last ac- cessed on 12th December, 2016.
India HIV Estimate 2015. Available on: http://www.naco. gov.in/sites/default/files/India%20HIV%20 Estimations% 202015.pdf. Last Accessed on 12th December, 2016.
Anthony s. Fauci, H. Clifford Lane. Ch.189: HIV Disease; AIDS and Related disorders. In: Harrisons principles of in- ternal medicine, Mc-Graw Hill, 18th Editon; 1506-87.
Engles EA, Rosenberg PS, O’Brien TR, Goedert JJ. Plasma HIV viral load in patients with hemophilia and late-state HIV disease: a measure of current immune suppression. Multicenter Hemophilia Cohort Study. Ann Intern Med. 1999 Aug 17;131 (4) : 256-64.
Das CP, Sawhney IMS. Neurological complications of HIV infection. Neurol India 1998;46:82-93
Rana HM, Doshi DA, Virpariya KM, Shah AN, Somani SS. A study of clinical profile of HIV positive patients with neurologicalmanifestations. HIV AIDS Rev 2011;10:76-9.
Fauci AS, Lane HC. Human immunodeficiency virus dis- ease: Harrison’s Principle of Internal Medicine. Vol 1. 17th ed. New York: Mcgraw Hill; 2008.pp. 1139-83.
Sircar AR, Tripathi AK, Choudhary SK, Misra R. Clinical profile of AIDS: A study at a referral hospital. J Assoc Phy- sicians India 1998;46:775-8.
Sonkar, et al. Neurological manifestation in HIV. North Am J Med. Sci., 2012; 4: 596-599.
Robinson-Papp J, Gonzalez-Duarte A, Simpson DM, Rivera- Mindt M, Morgello S Manhattan. HIV Brain Bank. The Roles of Ethnicity and Antiretrovirals in HIV-associated Polyneuropathy: A Pilot Study. J Acquir Immune Defi c Syndr., 2009; 51: 569-73.
Bolokadze N, Gabunia P, Ezugbaia M, Gatserelia L Khechi- ashvili G. Neurological complications in patients with HIV/AIDS. Georgian Med News, 2008; 165: 34-8.
Kovacs JA, Kovacs AA, Polis M, Wright WC, Gill VJ, Tuazon CU. Cryptococcosis in acquired immunodeficiency syndrome. Ann Intern Med 1985;103:533-8.
Alaka K.Despande, Mrinal M Patnaik. Nonopportunistic Neurologic Manifestations of the Human Immunodeficien- cy Virus: An Indian Study. Journal of the International AIDS Society 2005; 7 (2):1-10.
Deshpande AK, Patnaik MM. Non-opportunistic neurologic manifestations of the Human immunodeficiency virus: An Indian Study. J Int AIDS Soc 2005;7:2.
Oliveira JF, Greco DB, Oliveira GC, Christo PP, Guimaraes MD, Oliveira RC. Neurological disease in HIV infected pa- tients in the era of highly active anti retroviral treatment: A Brazilian experience. Rev Soc Bras Med Trop 2006;39:146-51.
Fauci AS, Lane HC. Human immunodeficiency virus dis- ease: Harrison’s Principle of Internal Medicine. Vol 1. 17th ed. New York: Mcgraw Hill; 2008.pp. 1139-83.
Rana HM, Doshi DA, Virpariya KM, Shah AN, Somani SS. A study of clinical profile of HIV positive patients with neurological manifestations. HIV AIDS Rev 2011;10:76-9.
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