HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study
Background. Studies on HIV-associated central nervous system (CNS) diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2013/709810 |
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| author | Henry Namme Luma Benjamin Clet Nguenkam Tchaleu Elvis Temfack Marie Solange Doualla Daniela Pamela Ntchankam Ndenga Yacouba Njankouo Mapoure Alfred Kinyuy Njamnshi Vincent-de-Paul Djientcheu |
| author_facet | Henry Namme Luma Benjamin Clet Nguenkam Tchaleu Elvis Temfack Marie Solange Doualla Daniela Pamela Ntchankam Ndenga Yacouba Njankouo Mapoure Alfred Kinyuy Njamnshi Vincent-de-Paul Djientcheu |
| author_sort | Henry Namme Luma |
| collection | DOAJ |
| description | Background. Studies on HIV-associated central nervous system (CNS) diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and December 31, 2009, we did at the Douala General Hospital a clinical case note review of 672 admitted adult (age ≥ 18 years) HIV-1 patients, and 44.6% (300/672) of whom were diagnosed and treated for HIV-associated CNS disease. Results. The mean age of the study population was years, and median CD4 count was 49 cells/mm3 (interquartile range (QR): 17–90). The most common clinical presentations were headache (83%), focal signs (40.6%), and fever (37.7%). Toxoplasma encephalitis and cryptococcal meningitis were the leading aetiologies of HIV-associated CNS disease in 32.3% and 25% of patients, respectively. Overall mortality was 49%. Primary central nervous system lymphoma (PCNSL) and bacterial meningitis had the highest case fatality rates of 100% followed by tuberculous meningitis (79.8%). Low CD4 count was an independent predictor of fatality (AOR: 3.2, 95%CI: 2.0–5.2). Conclusions. HIV-associated CNS disease is common in Douala. CNS symptoms in HIV patients need urgent investigation because of their association with diseases of high case fatality. |
| format | Article |
| id | doaj-art-d6fbec4392f94247a21486d1f7bfa2c3 |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | AIDS Research and Treatment |
| spelling | doaj-art-d6fbec4392f94247a21486d1f7bfa2c32025-02-03T01:30:04ZengWileyAIDS Research and Treatment2090-12402090-12592013-01-01201310.1155/2013/709810709810HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective StudyHenry Namme Luma0Benjamin Clet Nguenkam Tchaleu1Elvis Temfack2Marie Solange Doualla3Daniela Pamela Ntchankam Ndenga4Yacouba Njankouo Mapoure5Alfred Kinyuy Njamnshi6Vincent-de-Paul Djientcheu7Department of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, CameroonDepartment of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, CameroonDepartment of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, CameroonDepartment of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, CameroonUniversité des Montagnes, Bangangte, CameroonDepartment of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, CameroonFaculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, CameroonFaculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, CameroonBackground. Studies on HIV-associated central nervous system (CNS) diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and December 31, 2009, we did at the Douala General Hospital a clinical case note review of 672 admitted adult (age ≥ 18 years) HIV-1 patients, and 44.6% (300/672) of whom were diagnosed and treated for HIV-associated CNS disease. Results. The mean age of the study population was years, and median CD4 count was 49 cells/mm3 (interquartile range (QR): 17–90). The most common clinical presentations were headache (83%), focal signs (40.6%), and fever (37.7%). Toxoplasma encephalitis and cryptococcal meningitis were the leading aetiologies of HIV-associated CNS disease in 32.3% and 25% of patients, respectively. Overall mortality was 49%. Primary central nervous system lymphoma (PCNSL) and bacterial meningitis had the highest case fatality rates of 100% followed by tuberculous meningitis (79.8%). Low CD4 count was an independent predictor of fatality (AOR: 3.2, 95%CI: 2.0–5.2). Conclusions. HIV-associated CNS disease is common in Douala. CNS symptoms in HIV patients need urgent investigation because of their association with diseases of high case fatality.http://dx.doi.org/10.1155/2013/709810 |
| spellingShingle | Henry Namme Luma Benjamin Clet Nguenkam Tchaleu Elvis Temfack Marie Solange Doualla Daniela Pamela Ntchankam Ndenga Yacouba Njankouo Mapoure Alfred Kinyuy Njamnshi Vincent-de-Paul Djientcheu HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study AIDS Research and Treatment |
| title | HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study |
| title_full | HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study |
| title_fullStr | HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study |
| title_full_unstemmed | HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study |
| title_short | HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study |
| title_sort | hiv associated central nervous system disease in patients admitted at the douala general hospital between 2004 and 2009 a retrospective study |
| url | http://dx.doi.org/10.1155/2013/709810 |
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