Email this article The pattern of central nervous system lesion in HIV-infected patients in the specialized unit of an infectious diseases hospital
- Authors: Peregudova A.B.1, Shakhgil'dyan V.I.1, Tsvetkova O.O.1, Ermak T.N.1, Gruzdev B.M.1, Yuditskiy M.V.1, Tishkevich O.A.1, Shipulina O.Y.1, Al'vares Figeroa M.V.1, Safonova A.P.1, Dolgova E.A.1, Goncharov D.B.1, Peregudova AB2, Shakhgildyan VI3, Tsvetkova OO2, Yermak TN3, Gruzdev BM2, Yuditsky MV4, Tishkevich OA5, Shipulina OY.3, Alvares Figeroa MV3, Safonova AP3, Dolgova EA3, Goncharov DB6
-
Affiliations:
- Moscow City AIDS Center, Moscow Healthcare Department
- Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human Welfare
- G. A. Zakharyin Tuberculosis Hospital Three
- Infectious Diseases Hospital Two
- N. F. Gamaleya Research Institute of Epidemiology and Microbiology, Russian Academy of Medical Sciences
- Issue: Vol 82, No 11 (2010)
- Pages: 22-27
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/30708
- ID: 30708
Cite item
Full Text
Abstract
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 DepartmentMoscow 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 WelfareCentral 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 DepartmentMoscow 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 WelfareCentral 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 DepartmentMoscow City AIDS Center, Moscow Healthcare Department
M V Yuditsky
G. A. Zakharyin Tuberculosis Hospital ThreeG. A. Zakharyin Tuberculosis Hospital Three
O A Tishkevich
Infectious Diseases Hospital TwoInfectious Diseases Hospital Two
O Yu Shipulina
Central Central Research Institute of Epidemiology, Russian Inspectorate for the Protection of Consumer Rights and Human WelfareCentral 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 WelfareCentral 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 WelfareCentral 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 WelfareCentral 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 SciencesN. F. Gamaleya Research Institute of Epidemiology and Microbiology, Russian Academy of Medical Sciences
References
- 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.
- Покровский В. В. (ред.) ВИЧ-инфекция и СПИД. 2-е изд. М.: ГЭОТАР-Мед.; 2010.
- Ермак Т. Н., Перегудова А. Б., Груздев Б. М. Оппортунистические инфекции у ВИЧ-инфицированных: чудес не бывает. Тер. арх. 2006; 11: 80-81.
- 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.
- Шахгильдян В. И. Цитомегаловирусная инфекция: Лекции по инфекционным болезням / Под ред. Н. Д. Ющука, Ю. Я. Венгерова. 3-е изд. М.: Медицина; 2007.
- Яковлев Н. А., Жулев Н. М., Слюсарь Т. А. Нейроспид. Неврологические расстройства при ВИЧ-инфекции/ СПИДе. М.: МИА; 2005.
- Bartlett J. G. The Johns Hopkins hospital 2005-6 guide to medical care of patients with HIV infection 12-th ed. Philadelphia; 2005.
- Eggers C., Vortmeyer F., Emskotter T. Cerebral toxoplasmosis in a patient with the AIDS presenting as obstructive hydrocephalus. Clin. Neuropathol. 1995; 14: 51-54.
Supplementary files
