■神经系统表现是人类免疫缺陷病毒(HIV)患者的主要问题之一。次级频谱包括占位性病变(SOL),包括结核瘤,隐球菌病,念珠菌病,弓形虫病,原发性中枢神经系统淋巴瘤(PCNSL),和进行性多灶性白质脑病(PML)。
■为了评估神经系统表现,疾病结果,以及它们与HIV患者分化簇4(CD4)计数的关联。
■这个单中心,prospective,观察性研究是在三级保健研究所的普通医学系进行的,为期2年(2017年1月至2018年12月)。该研究包括150名已知或新诊断的CNSSOLHIV患者。体检,实验室调查,对每个病人进行成像,并注意到了调查结果。
■患者主要表现为偏瘫(52%),涉及额叶区域(38.7%),并被诊断为结核瘤(29.3%)。其他诊断为弓形虫病(22.7%),PML(17.3%),PCNSL(15.3%),脑脓肿(10%),和脑囊虫病(5.3%)。150名患者中,136人(90.7%)是幸存者,14人(9.3%)为非幸存者.弓形虫病(P<0.0001)和PCNSL(P=0.02)患者的平均CD4计数明显减少,与SOL的其他原因相比,结核瘤(P<0.0001)和脑脓肿(P=0.0009)的患者明显更高。此外,平均CD4计数与幸存者和非幸存者无显著相关性(P=0.28).
■在HIV患者中,弓形虫病和PCNSL中的CD4计数明显较低,高结核瘤和脑脓肿.
UNASSIGNED: Neurological manifestations are one of the major concerns for patients with human immunodeficiency virus (HIV). The secondary spectrum includes space-occupying lesions (SOL), including tuberculoma, cryptococcosis, candidiasis, toxoplasmosis, primary central nervous system lymphoma (PCNSL), and progressive multifocal leukoencephalopathy (PML).
UNASSIGNED: To assess the neurological manifestations, disease outcome, and their associations with cluster of differentiation 4 (CD4) counts in patients with HIV.
UNASSIGNED: This single-center, prospective, observational
study was performed in the Department of General Medicine of a tertiary care institute, over a period of 2 years (January 2017 to December 2018). The
study included 150 known or newly diagnosed HIV patients with CNS SOL. The physical examination, laboratory investigations, and imaging were conducted on every patient, and the findings were noted.
UNASSIGNED: The patients mainly presented with hemiparesis (52%), had involvement of the frontal region (38.7%), and were diagnosed with tuberculoma (29.3%). Other diagnoses were toxoplasmosis (22.7%), PML (17.3%), PCNSL (15.3%), brain abscess (10%), and neurocysticercosis (5.3%). Of 150 patients, 136 (90.7%) were survivors, while 14 (9.3%) were non-survivors. The mean CD4 count was significantly less in patients with toxoplasmosis (P < 0.0001) and PCNSL (P = 0.02), and significantly higher in patients with tuberculoma (P < 0.0001) and brain abscess (P = 0.0009) relative to other causes of SOL. Moreover, the mean CD4 count was not significantly associated with survivors and non-survivors (P = 0.28).
UNASSIGNED: In patients with HIV, CD4 count was significantly low in toxoplasmosis and PCNSL, and high in tuberculoma and brain abscess.