Neurological manifestations of HIV infection in Nigerians

Nervous system complications commonly accompany HIV infection and are associated with significant morbidity and mortality. HIV incidence has been progressively increasing in Nigeria, yet the neurological manifestations of the disease have not been systematically studied in Nigerians. This study aimed to describe the nature and frequency of neurological manifestations associated with HIV infection in a sample of 202 Nigerians. This was a prospective study of patients with documented HIV infection who attended a referral centre clinic in Abuja in 2003. A personal history, general and neurological examinations, and other relevant medical investigations were carried out for all subjects. A mini mental-state exam was carried out with those willing to cooperate. In all, 89 patients (44%) were diagnosed with at least one neurological disorder. Herpes zoster and cognitive impairment were the most frequent, each present in 12.3% of the study group. Peripheral neuropathy and facial palsy were also present, in 10.4% and 3.9% of subjects, respectively. Brain mass lesions, seizure disorder, cryptococcal meningitis, cord compression syndrome, and trigeminal neuralgia were also documented. There was no significant difference demographically between subjects with or without neurological impairment. Future studies in this area should utilise nerve conduction studies and more detailed testing of cognitive function to further characterise the neurological manifestations of HIV infection.