NEUROLOGICAL COMPLICATIONS OF HIV INFECTION, EPILEPTIC SEIZURES AND RISK OF DEATH

C. Pascu, A. Axelerad, I. Dumitru
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Abstract

Objectives: The study highlights the importance of epileptic seizures in HIV-positive patients with neurological complications, as well as the main neurological disorders that the seizures occurred in. The risk of death associated with seizure onset and the risk of death of the neurological conditions that the seizures arose from was calculated. Methods: 166 HIV-positive patients with neurological disorders admitted to the Clinical Infectious Diseases Hospital of Constanta between June 2012 and June 2020, were enrolled in an analytical, observational, and retrospective study. The data were extracted from the observation and follow-up sheets of these patients, which presented with neurological manifestations such as epileptic seizures. The data were processed using the IBM SPSS statistics 23 software. Results: Epileptic seizures were described in 47 patients (28,3%) and have been associated more with Progressive Multifocal Leukoencephalopathy (PML) and CNS Toxoplasmosis (CT) and less with HIV associated dementia (HAD) (p < 0,05). Extrapolating, the association of seizures with opportunistic infections versus other neurological complications was statistically significant (p < 0.05). The risk of death was 6 times higher for the patients diagnosed with opportunistic infections than for those suffering from other neurological conditions. In general, the risk of death associated with epileptic seizures in HIV positive patients was 3 times higher, compared to the risk of death in patients without epileptic seizures. Conclusions: The presence of epileptic seizures should accelerate the rhythm of the investigations being conducted; in order to establish the etiological diagnosis and decrease the morbidity and mortality of HIV-infected patients with neurological complications.
艾滋病毒感染的神经系统并发症、癫痫发作和死亡风险
目的:该研究强调了癫痫发作在hiv阳性患者神经系统并发症中的重要性,以及癫痫发作发生的主要神经系统疾病。计算了与癫痫发作相关的死亡风险以及癫痫发作引起的神经系统疾病的死亡风险。方法:对2012年6月至2020年6月在康斯坦察临床传染病医院住院的166例hiv阳性神经系统疾病患者进行分析性、观察性和回顾性研究。数据来自这些患者的观察和随访表,这些患者表现为神经学表现,如癫痫发作。采用IBM SPSS统计23软件对数据进行处理。结果:47例患者(28.3%)发生癫痫发作,与进行性多灶性脑白质病(PML)和中枢神经系统弓形虫病(CT)的相关性较高,与HIV相关痴呆(HAD)的相关性较低(p < 0.05)。推断,癫痫发作与机会性感染与其他神经系统并发症的关联具有统计学意义(p < 0.05)。被诊断为机会性感染的患者的死亡风险比患有其他神经系统疾病的患者高6倍。总的来说,与没有癫痫发作的患者相比,艾滋病毒阳性患者与癫痫发作相关的死亡风险高出3倍。结论:癫痫发作的存在应加快正在进行的调查的节奏;以建立病因学诊断和降低发病率和死亡率的艾滋病毒感染患者的神经系统并发症。
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