Neurological manifestations of HIV/AIDS to tertiary care hospital in KP, Peshawar, Pakistan

Background: Neurological manifestations affecting nervous system at all stages of HIV infection are common.it occurs in more than 40%of patients. They are the presenting features of HIV in 10–20% of cases. At autopsy the prevalence is 80%. Although an on going decline has been observed but mortality still remains high. Methods and materials: This study was carried out at lady Reading Hospital Peshawar, KP, Pakistan over a period of 8 years May 2009 to June 2017.A total of 100 cases of HIV of both genders aged >18 years, showing clinical evidence of nervous system involvement were included. Their clinical manifestations, lab investigations and neuroimaging were studied. MRI, NCS, EEG, were performed. Results: Tuberculosis meningitis was the most common presentation at secondary CNS illness (49%), followed by cryptococal meningitis (16%),and Cva (7%).Furthermore, 6% had neurosyphilis,5% had aids related dementia. Peripheral neuropathy was observed in 17%of patients. Headach was the most common symptom in 42% patients while seizures were noted in 35%of patients. CD4 count in TB meningitis and HIV associated encephalopathy were 115/ul and 83/ul respectively Conclusion: CNS tuberculosis was the most common secondary infection seen in HIV patients followed by cryptococal meningitis. A high index of clinical suspicion of neurological involvement in HIV patients helps in early diagnosis and early institution of specific treatment, which in turn decreases the morbidity and mortality considerably. Early treatment and prophylaxis of neurological problems in HIV patients is very important to decrease mortality rate.