HIV-Encephalopathy as initial manifestation of acquired immunodeficiency Syndrome in Yucatán State, Mexico

• Published in: Archives of medical research Vol. 35; no. 1; pp. 49 - 53
• Main Authors: Castro-Sansores, Carlos José, Góngora-Biachi, Renán A, González-Martı́nez, Pedro
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2004
• Subjects: Acquired Immunodeficiency Syndrome - complications; Acquired Immunodeficiency Syndrome - epidemiology; Acquired Immunodeficiency Syndrome - mortality; Acquired Immunodeficiency Syndrome - physiopathology; AIDS; AIDS Dementia Complex - epidemiology; AIDS Dementia Complex - mortality; AIDS Dementia Complex - physiopathology; Central nervous system toxoplasmosis; Female; HIV encephalopathy; Humans; Male; Mexico - epidemiology; Neurologic manifestation; Primary brain lymphoma; Retrospective Studies; Mexico; Neurologic manifestation; AIDS; Central nervous system toxoplasmosis; HIV encephalopathy; Primary brain lymphoma
• ISSN: 0188-4409; 1873-5487
• DOI: 10.1016/j.arcmed.2003.07.004

The frequency of neurologic manifestations of the central nervous system (CNS) as a defining disease of acquired immunodeficiency syndrome (AIDS) (neurologic manifestation defining disease [NMDD-AIDS]) varies according to geographic region. The aim of this study was to determine its prevalence among patients with AIDS diagnosed in the state of Yucatán, Mexico. We carried out a retrospective study in which AIDS cases reported at the Health Department in the state of Yucatán, Mexico from January 1983 to July 2001 were analyzed. Frequency of NMDD-AIDS and other pathologies were obtained. Frequency of other pathologies between patients with NMDD-AIDS and those without NMDD-AIDS was compared using χ 2 and/or Fisher exact test. A total of 1,175 subjects (1,054 [90%] men and 121 [10%] women) were included in the study. In 186 (16%), NMDD-AIDS were observed. The most common NMDD-AIDS was HIV-encephalopathy in 101 (54%) patients, CNS toxoplasmosis in 65 (35%), meningeal cryptococosis in 16 (8.6%), primary lymphoma of the brain in two (1%), and one (0.5%) case of progressive multifocal leukoencephalopathy. CD4 lymphocytes were statistically different between patients with NMDD-AIDS ( n = 47) and without ( n = 312) (mean: 65/μL (33–500) vs. 189/μL (2–989), p<0.005). Higher frequency of oropharyngeal candidiasis, pulmonary tuberculosis, herpetic stomatitis, and mortality was observed in patients with initial neurologic disease. Frequency of NMDD-AIDS was similar to some reports from the U.S. but lower than others from Mexico. HIV-encephalopathy was the most frequent manifestation. NMDD-AIDS were associated with advanced stage of immunodeficiency and influenced morbidity and mortality associated with AIDS.