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Published on: June 11, 2011
Peripheral facial paralysis associated with HIV infection: A case series and literature review
Pornchai Sathirapanya1, Chris Fujitnirun1, Suwanna Setthawatcharawanich1
1Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110 Thailand.
Objective:
The association between peripheral facial paralysis (PFP) and HIV infection has been scarcely explained. The authors aimed to describe the association between PFP and HIV infection status, along with the related co-morbidities and the outcomes of PFP, as well as the literature review on this topic.
Patients And Methods:
All HIV-infected patients who experienced PFP, both before and after a positive HIV serology test, between January 2002 and June 2015 were retrospectively reviewed. The patients' demographic data, clinical characteristics, HIV co-morbidities and outcomes of PFP were summarized. A literature review of PFP in HIV infection was also performed. Descriptive statistics were used in the data analysis. The Mann-Whitney U test was performed to compare the parameters between the current case series and cases from literature review to determine statistical significant differences (p < 0.05).
Results:
Sixteen patients (6 males and 10 females) were enrolled. Their median age was significantly higher than that of the cases in the literature review [46 (38, 49.75) vs. 33 (26, 41) years (p = 0.004)]. Nonetheless, a non-significant lower median CD4 count was observed [274 (134.5, 425.5) vs. 373 (265, 718) cells/μL (p = 0.058)]. In our series, unilateral PFP (UFP) was the most frequent, and it typically occurred long after a positive HIV serology test. However, bilateral PFP (BFP) was commonly found in the literature, and a simultaneous positive HIV serology test was reported in almost all cases. Consequently, most of our cases, except for those with HIV-related complications or co-morbidities, experienced a satisfactory recovery from PFP regardless of treatments received.
Conclusions:
Most of the cases in our series were UPF with a higher median age and a lower median CD4 count. Moreover, facial paralysis presented later in our series than in the previously reported cases in the literature. Most of our cases experienced satisfactory recovery of facial weakness.
Insights
Peripheral facial paralysis (PFP) in HIV patients often presents later and in a unilateral form, with most patients experiencing good recovery. This study clarifies the association between PFP and HIV status, co-morbidities, and outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Peripheral facial paralysis (PFP) association with Human Immunodeficiency Virus (HIV) infection is not well-understood.
- HIV infection can present with various neurological complications, including facial nerve palsy.
Purpose of the Study:
- To describe the association between PFP and HIV infection status.
- To analyze related co-morbidities and outcomes of PFP in HIV-infected individuals.
- To conduct a literature review on PFP in the context of HIV infection.
Main Methods:
- Retrospective review of HIV-infected patients with PFP from January 2002 to June 2015.
- Summarization of demographic data, clinical characteristics, HIV co-morbidities, and PFP outcomes.
- Comparative analysis with literature data using descriptive statistics and Mann-Whitney U test (p < 0.05).
Main Results:
- Sixteen patients (6 males, 10 females) were included; median age was 46 years, higher than literature (p=0.004).
- Median CD4 count was 274 cells/μL, non-significantly lower than literature (p=0.058).
- Unilateral PFP (UFP) was most frequent in this series, occurring later after HIV diagnosis; bilateral PFP (BFP) was common in literature, often simultaneous with diagnosis.
Conclusions:
- HIV-associated PFP in this series featured older patients, lower CD4 counts, and later onset compared to literature.
- Most cases, particularly UFP without HIV complications, showed satisfactory recovery.
- Findings highlight variations in PFP presentation and outcomes based on HIV status and co-morbidities.
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