Neurological disease in HIV-infected patients in the era of highly active antiretroviral treatment: a Brazilian experience.

To study characteristics of neurological disorders in HIV/AIDS patients and their relationship to highly active antiretroviral treatment, a cross-sectional study was conducted in an infectious disease public hospital in Belo Horizonte, Brazil, between February 1999 and March 2000. Of the 417 patients enrolled, neurological disease was observed in 194 (46.5%) and a new AIDS-defining neurological event developed in 23.7% of individuals. Toxoplasmosis (42.3%), cryptococcosis meningitis (12.9%) and tuberculosis (10.8%) were the most common causes of neurological complications. The majority (79.3%) of patients were on highly active antiretroviral treatment and these individuals using HAART showed higher CD4 cell counts (p = 0.014) and presented stable neurological disease (p = 0.0001), although no difference was found with respect to the profile of neurological complications. The neurological diseases continue to be a frequent complication of HIV/AIDS and infections are still its main causes in Brazil, even in the highly active antiretroviral treatment era.

Neurological disease in HIV-infected patients in the era of highly active antiretroviral treatment: a Brazilian experience

Com o objetivo de estudar as doencas neurológicas em pacientes HIV/AIDS e sua relacão com a terapia anti-retroviral altamente ativa, foi realizado estudo transversal em hospital público de doencas infecciosas de Belo Horizonte, Brasil, no período de fevereiro de 1999 a marco de 2000. Doenca neurológica foi observada em 194 (46,5%) dos 417 indivíduos incluídos e um novo episódio de doenca neurológica definidora de AIDS ocorreu em 23,7% pacientes. Toxoplasmose (42,3%), criptococose (12,9%) e tuberculose (10,8%) foram as principais causas de complicacões neurológicas. A maioria dos pacientes estava em uso de terapia anti-retroviral altamente ativa (79,3%) e esses indivíduos apresentaram maiores contagens de linfócitos CD4 (p = 0,014) e maior freqüência de doenca neurológica clinicamente estável, embora não tenha havido diferenca no perfil etiológico das complicacões neurológicas. As doencas neurológicas continuam sendo causas freqüentes de complicacões da infeccão pelo HIV/AIdS no Brasil, e a despeito da terapia anti-retroviral altamente ativa, as infeccões são ainda a principal etiologia das doencas do sistema nervoso.