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Primary headaches in HIV-infected patients
S M Mirsattari1, C Power, A Nath
1Department of Internal Medicine, Sections of Neurology, University of Manitoba Health Sciences Centre, Winnipeg, MB, Canada.
Headache
|December 23, 2004
Summary
Primary headaches, including migraine, are common in human immunodeficiency virus (HIV) patients. These headaches can become severe and chronic, often not responding to standard treatments.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Headaches in human immunodeficiency virus (HIV) patients can signify serious conditions like opportunistic infections or neoplasms.
- Differentiating between primary headaches and secondary causes is crucial for effective patient management.
Purpose of the Study:
- To describe the clinical characteristics of primary headaches in a cohort of HIV-infected individuals.
- To identify the prevalence and types of primary headaches within this population.
Main Methods:
- Retrospective analysis of 115 HIV-infected patients seen between 1990 and 1996.
- Categorization of headaches into primary and secondary causes.
- Subclassification of primary headaches into migraine, tension-type, and cluster headaches.
Main Results:
- Headaches were reported by 44% of patients; 66% of these were primary headaches.
- Migraine was the most frequent primary headache (76%), followed by tension-type (14%) and cluster headaches (10%).
- Chronic daily headaches developed in half of migraineurs and were refractory to conventional and antiretroviral therapies.
Conclusions:
- Primary headaches are the most common type in HIV patients and can emerge during severe immunosuppression.
- These headaches are often associated with comorbidities like depression and insomnia and typically do not require extensive neurological workup.
- Primary headaches in HIV patients frequently exhibit poor prognosis and resistance to standard treatments, including antiretroviral therapy.