The frequency and profile of neurology in black South African HIV infected (clade C) patients — A hospital-based prospective audit

Modi, Girish; Hari, Kapila; Modi, Mala; Mochan, Andre

doi:10.1016/j.jns.2007.01.001

Cited by 27 publications

(39 citation statements)

References 22 publications

(22 reference statements)

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“…Subtype C HIV-1 is also widespread in the Southern African countries. Interestingly, however, recent cohort studies in South Africa and Botswana, where C is the predominant subtype, showed that the incidence of HAD is much higher than that in India at 25 and 38% respectively [159-162]. In light of our earlier findings indicating reduced neuropathogenicity for subtype C HIV-1 [155], we were intrigued by the increased incidence data reported for subtype C HIV-1 cohorts in Southern Africa.…”

Section: Viral Genetic Determinantsmentioning

confidence: 82%

Viral and cellular factors underlying neuropathogenesis in HIV associated neurocognitive disorders (HAND)

2014

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As the HIV-1 epidemic enters its fourth decade, HIV-1 associated neurological disorders (HAND) continue to be a major concern in the infected population, despite the widespread use of anti-retroviral therapy. Advancing age and increased life expectancy of the HIV-1 infected population have been shown to increase the risk of cognitive dysfunction. Over the past 10 years, there has been a significant progress in our understanding of the mechanisms and the risk factors involved in the development of HAND. Key events that lead up to neuronal damage in HIV-1 infected individuals can be categorized based on the interaction of HIV-1 with the various cell types, including but not limited to macrophages, brain endothelial cells, microglia, astrocytes and the neurons. This review attempts to decipher these interactions, beginning with HIV-1 infection of macrophages and ultimately resulting in the release of neurotoxic viral and host products. These include: interaction with endothelial cells, resulting in the impairment of the blood brain barrier; interaction with the astrocytes, leading to metabolic and neurotransmitter imbalance; interactions with resident immune cells in the brain, leading to release of toxic cytokines and chemokines. We also review the mechanisms underlying neuronal damage caused by the factors mentioned above. We have attempted to bring together recent findings in these areas to help appreciate the viral and host factors that bring about neurological dysfunction. In addition, we review host factors and viral genotypic differences that affect phenotypic pathological outcomes, as well as recent advances in treatment options to specifically address the neurotoxic mechanisms in play.

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Section: Viral Genetic Determinantsmentioning

confidence: 82%

Viral and cellular factors underlying neuropathogenesis in HIV associated neurocognitive disorders (HAND)

2014

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“…However, the International HIV Dementia Scale (IHDS) [89,95,97,105,107-110,112,113,120,121] and the Sloan Memorial Kettering scale [86,89,90,98] were frequently used. Studies that used the IHDS reported a prevalence ranging from 21.1 to 80%.…”

Section: Resultsmentioning

confidence: 99%

Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

2014

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BackgroundSub-Saharan African (SSA) countries are experiencing rapid transitions with increased life expectancy. As a result the burden of age-related conditions such as neurodegenerative diseases might be increasing. We conducted a systematic review of published studies on common neurodegenerative diseases, and HIV-related neurocognitive impairment in SSA, in order to identify research gaps and inform prevention and control solutions.MethodsWe searched MEDLINE via PubMed, ‘Banque de Données de Santé Publique’ and the database of the ‘Institut d’Epidemiologie Neurologique et de Neurologie Tropicale’ from inception to February 2013 for published original studies from SSA on neurodegenerative diseases and HIV-related neurocognitive impairment. Screening and data extraction were conducted by two investigators. Bibliographies and citations of eligible studies were investigated.ResultsIn all 144 publications reporting on dementia (n = 49 publications, mainly Alzheimer disease), Parkinsonism (PD, n = 20), HIV-related neurocognitive impairment (n = 47), Huntington disease (HD, n = 19), amyotrophic lateral sclerosis (ALS, n = 15), cerebellar degeneration (n = 4) and Lewy body dementia (n = 1). Of these studies, largely based on prevalent cases from retrospective data on urban populations, half originated from Nigeria and South Africa. The prevalence of dementia (Alzheimer disease) varied between <1% and 10.1% (0.7% and 5.6%) in population-based studies and from <1% to 47.8% in hospital-based studies. Incidence of dementia (Alzheimer disease) ranged from 8.7 to 21.8/1000/year (9.5 to 11.1), and major risk factors were advanced age and female sex. HIV-related neurocognitive impairment’s prevalence (all from hospital-based studies) ranged from <1% to 80%. Population-based prevalence of PD and ALS varied from 10 to 235/100,000, and from 5 to 15/100,000 respectively while that for Huntington disease was 3.5/100,000. Equivalent figures for hospital based studies were the following: PD (0.41 to 7.2%), ALS (0.2 to 8.0/1000), and HD (0.2/100,000 to 46.0/100,000).ConclusionsThe body of literature on neurodegenerative disorders in SSA is large with regard to dementia and HIV-related neurocognitive disorders but limited for other neurodegenerative disorders. Shortcomings include few population-based studies, heterogeneous diagnostic criteria and uneven representation of countries on the continent. There are important knowledge gaps that need urgent action, in order to prepare the sub-continent for the anticipated local surge in neurodegenerative diseases.

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“…A Combination of clindamycin and pyrimethamine is an effective alternative therapy for patients who cannot tolerate sulfadiazine. [4,8,10] …”

Section: Cerebral Toxoplasmosismentioning

confidence: 99%

Neurological complication in HIV patients

Ritarwan

2018

IOP Conf. Ser.: Earth Environ. Sci.

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Abstract. Human Immunodeficiency Virus (HIV) is neurotropic and immunotropic, making themassive destruction of both systems. Although their amount has been reduced, there is still neurological presentations and complications of HIV remain common in the era of combination antiretroviral therapy (cART). Neurological opportunistic infections (OI) occur in advanced HIV diseases such as primary cerebral lymphoma, cryptococcal meningitis, cerebral toxoplasmosis, and progressive multifocal encephalopathy. Neurological problem directly related to HIV appear at any stage in the progress of HIV disease, from AIDS-associated dementia to the aseptic meningitis of primary HIV infection observed in subjects with an immune deficiency

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The frequency and profile of neurology in black South African HIV infected (clade C) patients — A hospital-based prospective audit

Cited by 27 publications

References 22 publications

Viral and cellular factors underlying neuropathogenesis in HIV associated neurocognitive disorders (HAND)

Viral and cellular factors underlying neuropathogenesis in HIV associated neurocognitive disorders (HAND)

Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

Neurological complication in HIV patients

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