PMID- 22726389
OWN - NLM
STAT- MEDLINE
DCOM- 20130419
LR  - 20121203
IS  - 1468-1293 (Electronic)
IS  - 1464-2662 (Linking)
VI  - 14
IP  - 1
DP  - 2013 Jan
TI  - Neurological opportunistic infections and neurological immune reconstitution 
      syndrome: impact of one decade of highly active antiretroviral treatment in a 
      tertiary hospital.
PG  - 21-30
LID - 10.1111/j.1468-1293.2012.01033.x [doi]
AB  - BACKGROUND: Despite the reported decrease in the incidence and mortality rates of 
      central nervous system (CNS) infections after the introduction of highly active 
      antiretroviral therapy (HAART), few studies have focused on the global incidence 
      and the relationship of these diseases with immune reconstitution inflammatory 
      syndrome (IRIS) in the developed world. METHODS: A descriptive cohort study of 
      all consecutive adult HIV-infected patients with CNS opportunistic infections 
      diagnosed between 2000 and 2010 in a tertiary hospital in Spain was carried out. 
      Demographic, clinical, laboratory, and microbiological data were recorded. 
      Patients were followed up until death or loss to follow-up or until 30 July 2011, 
      when the study finished. The significance of differences in the incidence rate 
      between early and late HAART periods was determined using the Mantel-Haenszel 
      test. Survival distribution was estimated using the Kaplan-Meier method. RESULTS: 
      A total of 110 cases of CNS infections were diagnosed. The incidence of CNS 
      opportunistic infections decreased from 9 cases per 1000 HIV-infected patients 
      per year in the early HAART period to 3.8 in the late HAART period (P = 0.04). 
      Overall, the estimated mean survival time was 58.8 months (95% confidence 
      interval 47.1-70.6 months). Of the 110 patients, 18 (16.4%) met the criteria of 
      IRIS, 10 (55.6%) were paradoxical and eight (44.4%) were unmasking. IRIS was not 
      associated with a higher mortality rate. CONCLUSIONS: The annual incidence of CNS 
      infections decreased progressively during the period of study. The mortality rate 
      associated with these diseases remains high despite HAART. The development of 
      IRIS associated with neurological infections had no influence on prognosis.
CI  - (c) 2012 British HIV Association.
FAU - Riveiro-Barciela, M
AU  - Riveiro-Barciela M
AD  - Infectious Diseases Department, University Hospital Vall d'Hebron, Autonomous 
      University of Barcelona, Barcelona, Spain.
FAU - Falco, V
AU  - Falco V
FAU - Burgos, J
AU  - Burgos J
FAU - Curran, A
AU  - Curran A
FAU - Van den Eynde, E
AU  - Van den Eynde E
FAU - Navarro, J
AU  - Navarro J
FAU - Villar del Saz, S
AU  - Villar del Saz S
FAU - Ocana, I
AU  - Ocana I
FAU - Ribera, E
AU  - Ribera E
FAU - Crespo, M
AU  - Crespo M
FAU - Pahissa, A
AU  - Pahissa A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120625
PL  - England
TA  - HIV Med
JT  - HIV medicine
JID - 100897392
SB  - IM
MH  - AIDS-Related Opportunistic Infections/epidemiology/etiology
MH  - Adult
MH  - Antiretroviral Therapy, Highly Active/*adverse effects
MH  - Central Nervous System Diseases/*epidemiology/etiology
MH  - Cohort Studies
MH  - Female
MH  - HIV Infections/complications/*drug therapy
MH  - *HIV-1
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*epidemiology/etiology
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Spain/epidemiology
EDAT- 2012/06/26 06:00
MHDA- 2013/04/23 06:00
CRDT- 2012/06/26 06:00
PHST- 2012/05/01 00:00 [accepted]
PHST- 2012/06/26 06:00 [entrez]
PHST- 2012/06/26 06:00 [pubmed]
PHST- 2013/04/23 06:00 [medline]
AID - 10.1111/j.1468-1293.2012.01033.x [doi]
PST - ppublish
SO  - HIV Med. 2013 Jan;14(1):21-30. doi: 10.1111/j.1468-1293.2012.01033.x. Epub 2012 
      Jun 25.