14th ICID - Poster Abstracts - International Society for Infectious ...

When citing these abstracts please use the following reference:
Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number.
Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1
is available electronically on http://www.sciencedirect.com
Final Abstract Number: 78.007
Session: HIV: Opportunistic Infections & Malignancies
Date: Friday, March 12, 2010
Time: 12:30-13:30
Room: Poster & Exhibition Area/Ground Level
Type: Poster Presentation
Opportunistic infections in central nervous system and associated neurologic disorders in HIV
infected patients in a Western Hospital of Venezuela, 2007-2009
A. Herrera-Martínez 1 , Y. Herrera 2 , A. M. Pineda 3
1 Hopsital Central Antonio María Pineda, Barquisimeto, Lara, Venezuela, 2 Hospital Central
Antonio María Pineda, Barquisimeto, Lara, Venezuela, 3 Hospital Central Antonio María Pineda,
Barquisimeto, Venezuela
Background: HIV-related central nervous system (CNS) disorders and infections represent
substantial personal, economic, and societal problems. However, its understanding is still lacking
in areas of some developing countries where HIV programs are still limited.
Methods: Herein we describe epidemiology, clinical features and diagnosis of opportunistic
infections in CNS and associated neurologic disorders in HIV infected patients in a western
hospital of Venezuela, January 2007 to September 2009. Monthly records of confirmed HIV
cases from the epidemiological archives were collected. All the patients with opportunistic
infections in CNS or associated neurologic disorders were selected. All the clinical relevant
variables were considered in this analysis.
Results: A total of 228 patients with HIV infection were treated during the study period; thirteen of
them (5%) presented neuropathology. Twelve (92%) were male, mean age was 35 years-old,
previous HIV was diagnosed in nine patients (69%) with a mean of 9 months, just 4 (30%) were
receiving antiretroviral treatment. The most common presented symptom was fever 6/13 (46%),
followed by muscular strength loss and headache 5/13 (38%), convulsions and conscience
alteration also had an important incidence 4/13 (30%) among other findings. Neurological
diagnoses were: 7/13 (53%) Cerebral Toxoplasmosis, 3/13 (23%) Central nervous system
Cryptococcus neoformans infection, 2/13 (15%) Cerebral Tuberculosis and 1/13 motor-sensitive
neuropathy (7%). Most of them (84%) also had associated infections or diagnoses: pancytopenia
(46%), Pneumocystis jirovecii pneumonia (38%) and candidiasis (30%); Kaposi sarcoma,
diabetes, pulmonary tuberculosis and chronic diarrhea were also presented. CD4 count mean
was 120 cells/mm3, CD8 count mean was 571 cells/mm3, and viral load was 12,120 copies/mm3
log 3.22 . CFR was 15%.
Conclusion: In this study neuroinfection was the first cause of hospitalization in HIV infected
patients with neurologic symptoms. Toxoplasmosis was the most common opportunistic
parenchymal brain lesion. The majority of patients had associated other opportunistic diagnosis.
Proper studies to determinate the real country prevalence and characteristics of these
neuropathologies are necessary. Early diagnosis is important in order to prevent potential
complications and sequels. Even more, clinical follow-up studies of these infected patients are
also needed in order to evaluate the evolution of disease and development of associated
conditions.