Grohmann S, Levy R, Bredesen D, Rosenblum M, Cohen B, Von Roenn J, Murphy R; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 478 (abstract no. Th.B.P.375).
Northwestern University Medical School, Chicago, IL, USA
To address the question of regional and risk group related variations in the incidence of AIDS-related neurological illness, we retrospectively evaluated the nature and frequency of neurological illness in two similar patient populations treated in University hospitals in San Francisco, California (SF) and Chicago, Illinois (CHI). In both SF and CHI, the predominant risk group for the acquisition of HIV infection was homosexual or bisexual exposure (99% and 79%, respectively), other major risk factors included IV drug abuse (2% SF, 7% CHI) and transfusion (greater than 1% SF, 1% CHI). Signs or symptoms of neurologic illness were observed in 482 of 1286 (37%) of patients in SF and in 58 of 205 (28%) of patients in CHI. Peripheral nervous system symptoms were noted in 79 patients in SF (6.1%) and in 20 patients in CHI (9.8%), while CNS dysfunction was observed in 474 patients in SF (37%) and in 41 patients in CHI (20%). Major specific pathologic diagnoses included (SF;CHI): HIV encephalopathy (100, 28%; 20, 34%), cryptococcal meningitis (68, 14%; 4, 7%), toxoplasmosis (53, 11%; 7, 12%), primary CNS lymphoma (25, 5%; 2, 3%) and PML (8, 2%; 3, 5%). Less common diagnoses included HSV, CMV or HVZ encephalitis (28, 5.8%; 1, 1.7%) and rare cases of CNS tuberculoma, and intracerebral hemorrhage secondary to thrombocytopenia. The data reflects a trend toward increasing neurologic illness with decreased T4 cell count. The mean T4 cell count in non-neurologically symptomatic patients was 143.5 + 14.4 while in neurologically symptomatic patients, the mean T4 count was 96.1 + 14.0. This trend may suggest that immunosuppression is a significant factor in the development of AIDS-related neurologic illness. The data further suggests that populations that are similar with respect to risk group, despite geographical location, may well have similar rates of neurologic disease.
Publication Types:
Keywords:
- AIDS Dementia Complex
- Bisexuality
- California
- Chicago
- Cities
- Encephalitis
- HIV Infections
- Homosexuality
- Humans
- Illinois
- Incidence
- Meningitis, Cryptococcal
- Risk Factors
- San Francisco
- Toxoplasmosis
- United States
Other ID:
UI: 102178383
From Meeting Abstracts