PMID- 24836573 OWN - NLM STAT- MEDLINE DCOM- 20150406 LR - 20220311 IS - 1878-5883 (Electronic) IS - 0022-510X (Linking) VI - 342 IP - 1-2 DP - 2014 Jul 15 TI - Spectrum of central nervous system disorders in hospitalized HIV/AIDS patients (2009-2011) at a major HIV/AIDS referral center in Beijing, China. PG - 88-92 LID - S0022-510X(14)00267-6 [pii] LID - 10.1016/j.jns.2014.04.031 [doi] AB - OBJECTIVE: To describe the spectrum of central nervous system (CNS) disorders and the contribution of neurological immune reconstitution inflammatory syndrome (IRIS) in hospitalized HIV/AIDS patients in You'an Hospital, Beijing China. STUDY DESIGN & METHODS: A retrospective observational study conducted over a 24-month period in You'an Hospial, a public sector referral hospital in Beijing, China. This study enrolled HIV seropositive patients who were admitted for developing new or recurrent neurological and (or) psychiatric symptoms from September 2009 to August 2011. Medical records were reviewed, demographic and clinical data were collected. Patients with peripheral neuropathy and those in delirium were excluded from this study. RESULTS: Of the total 620 HIV/AIDS hospital admissions from September 2009 to August 2011, 60 patients (9.7%) were hospitalized for CNS complications. The diagnosis of HIV infection was made after hospital admission in 16 of the 60 patients (26.7%), and 34 of them (56.7%) were already on antiretroviral therapy (ART) at the point of admission. The median CD4 cell count in these subjects was 39 (21-133) cells/mm(3), and 93.3% (56/60) of these patients belonged to stage IV HIV disease according to World Health Organization (WHO) classification. The most frequent diagnosis in these subjects included cryptococcal meningitis (CM, n=13, 22%), cerebral toxoplasmosis (n=10, 17%), and CNS tuberculosis (n=7, 11.7%). The overall mortality was 13% (8/60) and the case-fatality rates were: cryptococcal meningitis 7.7% (1/13), cerebral toxoplasmosis 20% (2/10) and tuberculous meningitis 28.6% (2/7). Of the 34 patients who were on ART, paradoxical neurological IRIS (the conditions of their existing CNS disorders get paradoxically worse after ART because of an exuberant inflammatory response directed towards opportunistic pathogens) was diagnosed in 4 patients (11.8%), 2 of whom related to TB infection (out of 5 TB patients, 40%), and the other 2 related to CM (out of 8 patients, 25%). CONCLUSION: Opportunistic infections, such as cryptococcal meningitis, cerebral toxoplasmosis and CNS tuberculosis were the most frequent diagnosis of CNS disease in hospitalized HIV/AIDS patients in You'an Hospital, Beijing, China. About 10% patients on ART were diagnosed as neurological IRIS in such a group of patients. CI - Copyright (c) 2014 Elsevier B.V. All rights reserved. FAU - Dai, Lili AU - Dai L AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Mahajan, Supriya D AU - Mahajan SD AD - Department of Medicine, Division of Allergy, Immunology, and Rheumatology, State University of New York at Buffalo, CTRC, 875 Ellicott St, Buffalo, NY 14203, USA. FAU - Guo, Caiping AU - Guo C AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Zhang, Tong AU - Zhang T AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Wang, Wen AU - Wang W AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Li, Tongzeng AU - Li T AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Jiang, Taiyi AU - Jiang T AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Wu, Hao AU - Wu H AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. FAU - Li, Ning AU - Li N AD - Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China. Electronic address: lining@bjyah.com.cn. LA - eng GR - R01LM009726- 01/LM/NLM NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20140430 PL - Netherlands TA - J Neurol Sci JT - Journal of the neurological sciences JID - 0375403 SB - IM MH - AIDS-Related Opportunistic Infections/complications/epidemiology/immunology/virology MH - Acquired Immunodeficiency Syndrome/*complications/epidemiology MH - Adolescent MH - Adult MH - Aged MH - Central Nervous System Infections/*complications/*epidemiology/virology MH - China/epidemiology MH - Female MH - Hospitalization/*statistics & numerical data MH - Humans MH - Immune Reconstitution Inflammatory Syndrome/epidemiology/etiology/immunology MH - Male MH - Middle Aged MH - Retrospective Studies MH - Severity of Illness Index MH - Young Adult OTO - NOTNLM OT - Central nervous system disorders OT - HIV OT - Immune reconstitution OT - Inflammatory syndrome OT - Opportunistic infection EDAT- 2014/05/20 06:00 MHDA- 2015/04/07 06:00 CRDT- 2014/05/20 06:00 PHST- 2014/02/03 00:00 [received] PHST- 2014/03/26 00:00 [revised] PHST- 2014/04/22 00:00 [accepted] PHST- 2014/05/20 06:00 [entrez] PHST- 2014/05/20 06:00 [pubmed] PHST- 2015/04/07 06:00 [medline] AID - S0022-510X(14)00267-6 [pii] AID - 10.1016/j.jns.2014.04.031 [doi] PST - ppublish SO - J Neurol Sci. 2014 Jul 15;342(1-2):88-92. doi: 10.1016/j.jns.2014.04.031. Epub 2014 Apr 30.