Clinical profile of neurological manifestations and CD4 counts in patient living with HIV cases and its outcome with treatment with ART at a tertiary hospital

 

Sanjay B Jagtap^1*, Pooja M Patil²

 

Abstract              Background: HIV/AIDS causes a wide spectrum of disease manifestations. Approximately 40% to 70% of all persons infected with HIV develop symptomatic neurological disorders. The present study was carried out to assess the prevalence of various neurological manifestations in HIV positive patients, its correlation with CD4 counts and whether there are any changes in these manifestations with ART. Material and Methods: Present study was single-Centre, prospective, descriptive cross-sectional study, conducted in patients with HIV/AIDS infection, Age between 15– 65 years, with neurological sign/symptoms. Results: By using Convenience sampling the minimum sample size of 50 was determined. Maximum cases belonged to the age group of 31-40 years (28.0%), followed by age categories of 21-30 years and 41-50 years (22.0%). There were 34 (68.0%) males and 16 (32.0%) females in the study. It was observed that maximum number of cases 26 (52.0%) had a CD4 count of ≤ 150 cells/mm³. About 17 (34.0%) cases had a CD4 count of 151-300 cells/mm³. Only 7 (14.0%) had a CD4 count above 300 cells/mm³. The mean CD4 counts were 169.8 ± 109.0 cells/mm³. The commonest symptom was altered sensorium (90.0%), followed by headache (70.0%), fever (68.0%), vomiting (66.0%) cases, generalized tonic clonic seizures (46.0%), memory loss (26.0%) and sensory deficit (8.0%) of the cases. There were multiple symptoms per case and the commonest combination of symptoms was vomiting and headache in 32 (64.0%) cases. Conclusion: The neurological manifestations particularly the sensory deficits, memory loss, higher motor functions and cerebellar signs are observed predominantly in cases with CD4 cell counts < 150 cells/mm3, showed a significant improvement with ART and increase in the CD4 cell counts.

Keywords: Neurological involvement, HIV/AIDS, tubercular Meningitis, tuberculoma ART, CD4 cell counts