Central nervous system lesions in HIV-infected patients in an epidemiologically unfavorable region


DOI: https://dx.doi.org/10.18565/epidem.2019.9.4.35-42

Khokhlova Z.A., Gileva R.A., Sereda T.V., Zolotukhina L.Yu., Tishkina A.P., Zakharova E.V.

1) Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Education of Continuing Professional Education, Ministry of Health of Russia, Novokuznetsk, Russia; 2) Novokuznetsk City Clinical Hospital Twenty-Nine, Novokuznetsk, Russia; 3) Novokuznetsk City Clinical Infectious Diseases Hospital Eight, Novokuznetsk, Russia
Objective. To determine the pattern of central nervous system (CNS) lesions and to characterize their clinical and laboratory features in patients with HIV infection in Novokuznetsk.
Subjects and methods. The investigators analyzed the 2006-2018 data on the incidence of HIV infection in Novokuznetsk. They conducted a clinical, laboratory, and instrumental examination in 95 HIV-infected patients admitted to hospital for suspected neuroinfection.
Results. The incidence of HIV infection in Novokuznetsk steadily exceeds Russia’s average. The pattern of CNS lesions was established to include secondary meningitis/encephalitis in the presence of bacterial or Candida sepsis, tuberculosis, toxoplasmosis, cryptococcosis, cytomegalovirus encephalitis, lymphoma, HIV-associated encephalitis, encephalopathy, subarachnoid hemorrhage, and progressive multifocal leukoencephalopathy. Three fourths of patients had Stage 4B HIV infection (AIDS). A fatal outcome occurred in 48 cases; 7 patients were transferred to other hospitals.
Conclusion. A central nervous system lesion in HIV-infected patients in the endemic territory is recorded mainly in the late stages of the disease and is characterized by polyetiology, nonspecific clinical presentations, high mortality rates, and difficulties in clinical diagnosis and decoding of the etiology of the disease.
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Literature

  • Boyko A.N., Mazus A.I., Tsyganova E.V., Ovcharov V.V., Boyko O.V., Serkov S.V., Gusev E.I. [Neurological manifestations of HIV-infection]. Zhurnal nevrologii i psikhiatrii 2012; 2(9): 23–8. (In Russ.).

  • Belyakov N.A., Trofimova T.N., Rassokhin V.V. [Diagnostics and mechanisms of the central nervous system disorder]. Meditsinskiy akademicheskiy zhurnal 2012; 12(2): 56–67. (In Russ.).

  • Gustov A.V., Ruina E.A., Shilov D.V., Erokhina M.N. [Clinacal options of the central nervous system disorder of patients with HIV-infection]. Sovremennyye tekhnologii v meditsine 2010; (3): 61–5. (In Russ.).

  • Shakhgil’dyan V.I., Yadrikhinskaya M.S., Safonova A.P., Domonova E.A., Shipulina O.Yu., Al’vares-Figeroa M.V., Dolgova E.A., Tishkevich O.A. [The structure of secondary diseases and present-day approaches to laboratory diagnostics for patients with HIV-infection]. Èpidemiologiâ i infekcionnye bolezni. Аktual’nye voprosy 2015; (1): 24–30. (In Russ.).

  • Peregudova A.B., Shakhgil’dyan V.I., Tsvetkova O.O., Ermak T.N., Gruzdev B.M., Yuditskiy M.V., Tishkevich O.A., Shipulina O.Yu., Al’vares-Figeroa M.V., Safonova A.P., Dolgova E.A., Goncharov D.B. [The structure of the central nervous system disorder of patients with HIV-infection in specialized department of Infectious Diseases Hospital]. Terapevticheskiy arkhiv 2010; 82(11): 22–7. (In Russ.).

  • Shelomov A.S., Stepanova E.V., Leonova O.N., Smirnova N.L. [Opportunistic infections as causes of central nervous system disorders of patients with HIV-infection]. Zhurnal infektologii 2016; 8(3): 107–15. (In Russ.).

  • Charushina I.P., Vorob’eva N.N., Lyapustin S.B. [Diagnostics and treatment of cryptococcal meningoencephalitis in patients with HIV-infection]. Lechenie i profilaktika 2013; 4(8): 58–61. (In Russ.).

  • Sarsekeeva N.E. [HIV-infection and toxoplasmosis].Fundamental’nye issledovaniya 2014; (10): 1976–8. (In Russ.).

  • Ermak T.N., Mikhaylova N.R., Kalinina T.N., Pruss V.F. [Celebral toxoplasmosis: addition to HIV clinical picture]. Infektsionnye bolezni 2015; 2(13): 68–9. (In Russ.).

  • Briasolis A., Syros G., Apostolidou E., Psevdos G., Sharp V. [Bacterial celebral abscess, accompanied by celebral toxoplasmosis in patient with AIDS]. AIDS 2010; 3(3): 259–60. (In Russ.).

  • Pivnik A.V., Tumanova M.V., Seregin N.V., Parkhomenko Yu.G., Tishkevich O.A., Kovrigina A.M., Likunov E.B. [Lymphoms in HIV patients: literature review]. Klinicheskaya onkogematologiya 2014; 7(3): 264–77. (In Russ.).

  • Khokhlova Z.A., Gileva R.A., Sereda T.V., Nikolaeva N.A., Tishkina A.P., Zolotukhina L.Yu., Kirillova Yu.M. [Generalized lymphoma, associated with HIV-infection]. Lechashchiy vrach 2018; (8): 64–8. (In Russ.).

  • Fursova L.A., Sinevich P.A. [Celebrovascular diseases in HIV-infection]. Mezhdunarodnyy nevrologicheskiy zhurnal 2017; 89(3): 136–42. (In Russ.).

  • Ladnaya N.M. [Monitoring and the situation,s assessment on HIV-infection in Russia]. https://congress-ph.ru/common/htdocs/upload/fm/vich/18/05-10-18/prez/A-04-10-01.pdf (In Russ.).

  • Pokrovskу V.V., Yurin O.G., Kravchenko A.V., Belyaeva V.V., Ermak T.N., Kanestri V.G., Shahgil’dyan V.I., Kozyrina N.V., Buravcova V.V., Narsiya R.S., Hohlova O.N., Pokrovskaya A.V., Efremova O.S., Konnov V.V., Kuimova U.A., Popova A.A. [Recommendations for the treatment of HIV infection and related diseases, chemoprophylaxis of HIV infection]. Èpidemiologiâ i infekcionnye bolezni. Аktual’nye voprosy 2018; (6, prilozhenie). (In Russ.).


    • About the Autors

    Prof. Zinaida A. Khokhlova, MD, Head, Department of the Infectious Diseases, Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Education of Continuing Professional Education, Ministry of Health of Russia, Novokuznetsk, Russia; е-mail: zinaidaxoxlowa@yandex.ru; ORCID: 0000-0001-7306-1849.
    Raisa A. Gileva, Аssociate Рrofessor, Department of the Infectious Diseases, Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Education of Continuing Professional Education, Ministry of Health of Russia, Novokuznetsk, Russia; е-mail: isen1938@yandex.ru; ORCID: http://orcid.org/0000-0001-5535-5800
    Tatyana V. Sereda, Сand. Med. Sci., Аssociate Рrofessor, Department of the Infectious Diseases, Novokuznetsk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical Education of Continuing Professional Education, Ministry of Health of Russia, Novokuznetsk, Russia; е-mail: stv11419@mail.ru; ORCID: http://orcid.org/ 0000 0003-2859-3832
    Larisa Yu. Zolotukhina, Infectiologist, Novokuznetsk City Clinical Infectious Diseases Hospital Eight, Novokuznetsk, Russia; е-mail: lara_zolotuhina@mail.ru
    Anna P. Tishkina, Head of Department, Novokuznetsk City Clinical Infectious Diseases Hospital Eight, Novokuznetsk, Russia; е-mail: anna.tiskina11@gmail.com; ORCID: http://orcid.org/0000-0002-7234-9012
    Elena V. Zakharova, Сand. Med. Sci., Principal Physician, Novokuznetsk City Clinical Infectious Diseases Hospital Eight, Novokuznetsk, Russia; е-mail: elena.zacharova. 1961@mail.ru; ORCID: http://orcid.org/0000-0002-6261-2112

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