Contribuição ao conhecimento das alterações neurológicas em pacientes com SIDA

Câmara, Vilma Duarte; Tavares, Walter; Rocha, Marcy Pereira Ribeiro da; Chimelu, Leila Cardão; Dumas-Hahn, Myriam

doi:10.1590/s0004-282x1995000100009

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Though considered the most common cerebral mass lesion in patients with neurologic manifestations of AIDS, the prevalence of such opportunistic infection is no higher than 40% in the world literature (1) and even in other studies in Brazil. (16) The clinical presentation of the neurotoxoplasmosis varied from focal motor signs to headache, from coma and convulsions to ataxia and spastic paraparesia. Focal signs were observed in 24% of the patients and headache in 16% of them.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent Brazilian review of cases, 3 patients out of 154 had no neurologic signs or symptoms but presented lesions of the nervous system: these 3 patients had neurotoxoplasmosis. (16) Cryptococcic meningitis is a frequent fungal infection in AIDS patients, (5) often occurring with minimal inflammation due to the immunodeficiency. Acute symptoms of meningitis may be absent due to this subtle inflammation and, as in our four patients, headache and behavioural alterations may be the only signs of this infection.…”

Section: Discussionmentioning

confidence: 99%

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Neurologic manifestations of AIDS: a review of fifty cases in Santos

Fragoso¹,

Mendes²,

Adamo³

et al. 1998

Sao Paulo Med. J.

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Objective: To review the neurologic manifestations of AIDS in patients who were admitted to Hospital Guilherme Álvaro (HGA) due to any clinical manifestation of the disease. Design: Case series. Patients: All HIV+ patients admitted to the Faculty Hospital (HGA) between July 96 and April 97 were included in this review. Results: From the 117 HIV+ patients admitted to hospitalization due to AIDS-related symptoms, 50 (42.7%) presented neurologic manifestations. The most prevalent of these was neurotoxoplamosis (68%), but a variety of other neurologic diseases were observed. Only 36% of these 50 patients had neurological signs and symptoms as the main complaint for admission, 12% of the patients had at least complained of some neurologic dysfunction at the time of admission and 10% had no neurologic complaints at all. The remaining 42% (21 patients) only complained of neurologic manifestations of AIDS when specifically asked. Conclusions: The prevalence of neurologic manifestations of AIDS is very high in patients admitted to hospital. Even in the absence of neurologic-related complaints, these patients have to be carefully questioned and examined in the search for an underlying neurologic complication which may present high morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Fragoso¹,

Mendes²,

Adamo³

et al. 1998

Sao Paulo Med. J.

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Highly active antiretroviral therapy access and neurological complications of human immunodeficiency virus infection: Impact versus resources in Brazil

Silva

Araújo²

2005

Journal of NeuroVirology

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Currently, there are almost 600,000 human immunodeficiency virus (HIV)-infected individuals in Brazil. From 1984 to 2004, 362,364 acquired immunodeficiency virus (AIDS) cases were officially reported and 155,000 patients are under highly active antiretroviral therapy (HAART) treatment. Like in developed countries, universal access to treatment in Brazil has definitively changed both mortality and morbidity of AIDS. Today, the median survival time is 58 months, with a 2-year survival of 63%, versus 18 months before HAART. As expected, the incidence of nervous system opportunistic infectious diseases and tumors has also decreased in Brazil. However, few Brazilian reports about neurological manifestations of HIV infection are available, particularly after the beginning of more effective antiretroviral therapy. Autopsy series report that toxoplasmosis is the most prevalent neurological disease, followed by cryptococcosis and HIV encephalitis. A much lower incidence of progressive multifocal leukoencephalopathy has been described in Brazil than in reports from developed countries. A possibility for this discrepancy could be differences in terms of JC virus (JCV) isolates or even the interactions between JCV and local HIV strains. Some particularities about the involvement of the nervous system in Brazilian patients are worthy of note, such as the occurrence of central nervous system involvement in chronic Chagas' disease in patients with AIDS, and the concomitance of leprosy and HIV infection. National surveillance of neurological manifestations of HIV infection is needed to ascertain the real impact of HAART on nervous system diseases associated with AIDS in Brazil.

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

Oliveira

Greco

Oliveira

et al. 2006

Rev. Soc. Bras. Med. Trop.

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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. Key-words: HIV infection. AIDS. Neurological disease. Highly active antiretroviral treatment. Brazil. RESUMOCom o objetivo de estudar as doenças neurológicas em pacientes HIV/AIDS e sua relação com a terapia anti-retroviral altamente ativa, foi realizado estudo transversal em hospital público de doenças infecciosas de Belo Horizonte, Brasil, no período de fevereiro de 1999 a março de 2000. Doença neurológica foi observada em 194 (46,5%) dos 417 indivíduos incluídos e um novo episódio de doença neurológica definidora de AIDS ocorreu em 23,7% pacientes. Toxoplasmose (42,3%), criptococose (12,9%) e tuberculose (10,8%) foram as principais causas de complicações 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 doença neurológica clinicamente estável, embora não tenha havido diferença no perfil etiológico das complicações neurológicas. As doenças neurológicas continuam sendo causas freqüentes de complicações da infecção pelo HIV/AIDS no Brasil, e a despeito da terapia anti-retroviral altamente ativa, as infecções são ainda a principal etiologia das doenças do sistema nervoso. Palavras-chaves: Infecção pelo HIV. SIDA. Doença neurológica. Terapia anti-retroviral altamente ativa. Brasil.

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Contribuição ao conhecimento das alterações neurológicas em pacientes com SIDA

Cited by 3 publications

References 6 publications

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Neurologic manifestations of AIDS: a review of fifty cases in Santos

Highly active antiretroviral therapy access and neurological complications of human immunodeficiency virus infection: Impact versus resources in Brazil

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

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