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Human immunodeficiency virus-related headache

B J Brew¹, J Miller

¹Centre for Immunology, St. Vincent's Hospital, Sydney, Australia.

|June 1, 1993

Summary

Headache is a distinct clinical issue in advanced human immunodeficiency virus (HIV) infection, differing from HIV aseptic meningitis by the absence of cerebrospinal fluid pleocytosis. This condition affects 2.8% of HIV service admissions.

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Area of Science:

Neurology
Infectious Diseases
Immunology

Background:

Headache is a common symptom in patients with human immunodeficiency virus (HIV).
Distinguishing HIV-related headaches from other causes is crucial for appropriate management.
Previous studies have explored various neurological complications of HIV, but a distinct headache entity requires further characterization.

Purpose of the Study:

To determine the frequency and clinical characteristics of headaches in human immunodeficiency virus (HIV)-infected patients after excluding other causes.
To compare the incidence of these headaches in HIV-infected versus HIV-negative individuals.
To investigate the relationship between this specific headache and advanced HIV infection, including AIDS dementia complex.

Main Methods:

Retrospective assessment of patient admissions over a 1-year period.
Inclusion criteria: HIV-infected patients with headache and exclusion of other causes; HIV-negative patients for comparison.
Data collection included clinical characteristics, CD4+ cell counts, and follow-up for AIDS dementia complex.

Main Results:

HIV-related headaches occurred in 2.8% of HIV service admissions versus 0.2% of neurology service admissions.
Affected patients had advanced HIV infection with low CD4+ cell counts (mean 58.9 +/- 80.3).
Headache features resembled HIV aseptic meningitis but were not linked to AIDS dementia complex.

Conclusions:

A distinct clinical entity of headache related to advanced HIV infection is proposed.
This condition is similar to HIV aseptic meningitis but lacks cerebrospinal fluid (CSF) pleocytosis, likely due to lymphocyte depletion.
The findings suggest a specific neurological manifestation of advanced HIV disease.

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