The pattern of central nervous system lesion in HIV-infected patients in the specialized unit of an infectious diseases hospital

Abstract


Aim. To define the incidence and features of brain lesion (BL) in HIV-infected inpatients.
Subjects and methods. Four hundred and fifty-eight patients with Stage 4B HIV infection (AIDS) and central nervous system (CNS) lesion admitted to Infectious Diseases Hospital Two, Moscow, were followed up in 2003-2009. The authors used cerebrospinal fluid (CSF) microscopic and bacteriological assays for DNA of T. gondii, M. tuberculosis, herpes simplex virus (HSV) types 1 and 2, cytomegalovirus (CMV), HSV type 6, and varicella-zoster virus, Cr. neoformans, C. albicans, C. glabrata, and C. krusei. Blood and CSF were tested for IgM and IgG T. gondii antibodies; brain magnetic resonance imaging was carried out.
Results. In patients with late-stage HIV infection, the principal cause of neurological diseases was cerebral toxoplasmosis (34.7% of BL cases) and a generalized process involving the brain, lung, heart, liver, and eyes in 11.5%. There was commonly cerebral toxoplasmosis concurrent with CMV infection with clinical manifestations. 16-32% of the inpatients developed tuberculosis meningoencephalitis that was a manifestation of hematogenous disseminated tuberculosis involving the lung. There was a rise in the incidence of cancers (brain lymphomas, astrocytomas) running with CNS lesion. Mental disorders progressing to dementia were a distinctive property of CMV ventriculoencephalitis, one of the leading factors in the development of AIDS dementia complex. Molecular diagnostic techniques are needed to ascertain the etiology of BL in HIV infection.
Conclusion. The CSF test for DNA of causative agents is a specific and most sensitive method for diagnosing a relevant CNS lesion.

About the authors

Alla Borisovna Peregudova

Vasiliy Iosifovich Shakhgil'dyan

Ol'ga Olegovna Tsvetkova

Tat'yana Nikiforovna Ermak

Boris Marlenovich Gruzdev

Mikhail Vladimirovich Yuditskiy

Oleg Aleksandrovich Tishkevich

Ol'ga Yur'evna Shipulina

Mariya Viktorovna Al'vares Figeroa

Anna Petrovna Safonova

Ekaterina Alekseevna Dolgova

Dmitriy Borisovich Goncharov

A B Peregudova

Moscow City AIDS Center, Moscow Healthcare Department

Moscow City AIDS Center, Moscow Healthcare Department

V I Shakhgildyan

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

O O Tsvetkova

Moscow City AIDS Center, Moscow Healthcare Department

Moscow City AIDS Center, Moscow Healthcare Department

T N Yermak

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

B M Gruzdev

Moscow City AIDS Center, Moscow Healthcare Department

Moscow City AIDS Center, Moscow Healthcare Department

M V Yuditsky

G. A. Zakharyin Tuberculosis Hospital Three

G. A. Zakharyin Tuberculosis Hospital Three

O A Tishkevich

Infectious Diseases Hospital Two

Infectious Diseases Hospital Two

O Yu Shipulina

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

M V Alvares Figeroa

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

A P Safonova

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

E A Dolgova

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare

D B Goncharov

N. F. Gamaleya Research Institute of Epidemiology and Microbiology, Russian Academy of Medical Sciences

N. F. Gamaleya Research Institute of Epidemiology and Microbiology, Russian Academy of Medical Sciences

References

  1. Беляева В. В., Шахгильдян В. И., Кравченко А. В. и др. Деменция как следствие цитомегаловирусного энцефалита Журн. нефрол. и психиатр. 1999; 99(4): 29-32.
  2. Покровский В. В. (ред.) ВИЧ-инфекция и СПИД. 2-е изд. М.: ГЭОТАР-Мед.; 2010.
  3. Ермак Т. Н., Перегудова А. Б., Груздев Б. М. Оппортунистические инфекции у ВИЧ-инфицированных: чудес не бывает. Тер. арх. 2006; 11: 80-81.
  4. Перегудова А. Б., Шахгильдян В. И., Гончаров Д. Б. и др. Клинические особенности и диагностическое значение лабораторных маркеров церебрального токсоплазмоза у больных ВИЧ-инфекцией. Тер. арх. 2007; 79(11): 31-35.
  5. Шахгильдян В. И. Цитомегаловирусная инфекция: Лекции по инфекционным болезням / Под ред. Н. Д. Ющука, Ю. Я. Венгерова. 3-е изд. М.: Медицина; 2007.
  6. Яковлев Н. А., Жулев Н. М., Слюсарь Т. А. Нейроспид. Неврологические расстройства при ВИЧ-инфекции/ СПИДе. М.: МИА; 2005.
  7. Bartlett J. G. The Johns Hopkins hospital 2005-6 guide to medical care of patients with HIV infection 12-th ed. Philadelphia; 2005.
  8. Eggers C., Vortmeyer F., Emskotter T. Cerebral toxoplasmosis in a patient with the AIDS presenting as obstructive hydrocephalus. Clin. Neuropathol. 1995; 14: 51-54.

Statistics

Views

Abstract - 92

Cited-By


Article Metrics

Metrics Loading ...

Refbacks

  • There are currently no refbacks.

Copyright (c) 2010 Peregudova A.B., Shakhgil'dyan V.I., Tsvetkova O.O., Ermak T.N., Gruzdev B.M., Yuditskiy M.V., Tishkevich O.A., Shipulina O.Y., Al'vares Figeroa M.V., Safonova A.P., Dolgova E.A., Goncharov D.B., Peregudova A.B., Shakhgildyan V.I., Tsvetkova O.O., Yermak T.N., Gruzdev B.M., Yuditsky M.V., Tishkevich O.A., Shipulina O.Y., Alvares Figeroa M.V., Safonova A.P., Dolgova E.A., Goncharov D.B.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Novoslobodskaya str 31c4., Moscow, 127005, Russian Federation

Managing Editor:

 

© 2018 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies