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Neurologic signs and symptoms frequently manifest in acute HIV infection.
- Source :
-
Neurology [Neurology] 2016 Jul 12; Vol. 87 (2), pp. 148-54. Date of Electronic Publication: 2016 Jun 10. - Publication Year :
- 2016
-
Abstract
- Objective: To determine the incidence, timing, and severity of neurologic findings in acute HIV infection (pre-antibody seroconversion), as well as persistence with combination antiretroviral therapy (cART).<br />Methods: Participants identified with acute HIV were enrolled, underwent structured neurologic evaluations, immediately initiated cART, and were followed with neurologic evaluations at 4 and 12 weeks. Concurrent brain MRIs and both viral and inflammatory markers in plasma and CSF were obtained.<br />Results: Median estimated HIV infection duration was 19 days (range 3-56) at study entry for the 139 participants evaluated. Seventy-three participants (53%) experienced one or more neurologic findings in the 12 weeks after diagnosis, with one developing a fulminant neurologic manifestation (Guillain-Barré syndrome). A total of 245 neurologic findings were noted, reflecting cognitive symptoms (33%), motor findings (34%), and neuropathy (11%). Nearly half of the neurologic findings (n = 121, 49%) occurred at diagnosis, prior to cART initiation, and most of these (n = 110, 90%) remitted concurrent with 1 month on treatment. Only 9% of neurologic findings (n = 22) persisted at 24 weeks on cART. Nearly all neurologic findings (n = 236, 96%) were categorized as mild in severity. No structural neuroimaging abnormalities were observed. Participants with neurologic findings had a higher mean plasma log10 HIV RNA at diagnosis compared to those without neurologic findings (5.9 vs 5.4; p = 0.006).<br />Conclusions: Acute HIV infection is commonly associated with mild neurologic findings that largely remit while on treatment, and may be mediated by direct viral factors. Severe neurologic manifestations are infrequent in treated acute HIV.<br /> (© 2016 American Academy of Neurology.)
- Subjects :
- Acute Disease
Adult
Anti-Retroviral Agents therapeutic use
Biomarkers blood
Biomarkers cerebrospinal fluid
Brain diagnostic imaging
Cognition
Cohort Studies
Female
Follow-Up Studies
HIV Infections drug therapy
HIV Infections epidemiology
Humans
Incidence
Magnetic Resonance Imaging
Male
Motor Activity
Severity of Illness Index
Time Factors
HIV Infections physiopathology
HIV Infections psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1526-632X
- Volume :
- 87
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Neurology
- Publication Type :
- Academic Journal
- Accession number :
- 27287217
- Full Text :
- https://doi.org/10.1212/WNL.0000000000002837