Neurologic manifestations of HIV infection: an Indian hospital-based study

Neurologic manifestations affecting the nervous system at all levels and stages of HIV infection are common and increasing with the extended survival of HIV-positive persons. A study was conducted to document neurologic events in HIV cases in India, a country in which persons are primarily infected with subtype C HIV-1. The study's aims were to evaluate the incidence of admissions due to HIV-related neurologic events, to study the diverse clinical presentations of neurologic abnormalities, and to correlate these with the CD4 count. The demographic and clinical data of 1606 HIV-positive patients were analyzed by a retrospective review of the case records. In 411 patients, 486 single or coexisting neurologic manifestations were found--an overall prevalence of 25.6%, which ranged from 15.8% in 1993 to 26.6% in 2003. Meningitis was the most common CNS infection in patients with HIV/AIDS (39.4%), followed by mass lesions (27.5%). Most of these complications were observed in the advanced stages of infection. CD4 counts were performed in 29.9% of the cases with neurologic events, mainly on those seen since 2000, and the mean CD4 count was 89 cells/microL. This study revealed not only the high prevalence of various neurologic events but also their nature, clinical presentation, and symptoms. The results underscore the need for precise diagnosis and parallel assessment of CD4 counts, which is important for the practical management of an specific therapy for the HIV-infected patient.