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Neurologic signs and symptoms frequently manifest in acute HIV infection
- Source :
- Neurology, vol 87, iss 2
- Publication Year :
- 2016
- Publisher :
- eScholarship, University of California, 2016.
-
Abstract
- ObjectiveTo 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).MethodsParticipants 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.ResultsMedian 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).ConclusionsAcute 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.
- Subjects :
- Adult
Male
Time Factors
Clinical Sciences
HIV Infections
Motor Activity
Severity of Illness Index
Cohort Studies
Cognition
Clinical Research
Humans
Pediatric
Neurology & Neurosurgery
Incidence
Neurosciences
Brain
Magnetic Resonance Imaging
Mental Health
Infectious Diseases
Anti-Retroviral Agents
Acute Disease
HIV/AIDS
SEARCH 010/RV254 Study Group
Female
Cognitive Sciences
Infection
Biomarkers
Follow-Up Studies
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Neurology, vol 87, iss 2
- Accession number :
- edsair.od.......325..9f56a630497fbdc0aacc829aa89f205e