Background: Even though the prevalence of HIV infection among the adult population in Ethiopia was estimated\r\nto be 2.2% in 2008, the studies on the pattern of neurological manifestations are rare. The aim of this retrospective\r\nstudy was to assess the pattern and predictors of mortality of HIV/AIDS patients with neurologic manifestations.\r\nMethods: Medical records of 347 patients (age =13 years) admitted to Tikur Anbesa Hospital from September 2002\r\nto August 2009 were reviewed and demographic and clinical data were collected.\r\nResults: Data from 347 patients were analysed. The mean age was 34.6 years. The diagnosis of HIV was made\r\nbefore current admission in 33.7% and 15.6% were on antiretroviral therapy (ART). Causes of neurological\r\nmanifestation were: cerebral toxoplasmosis (36.6%), tuberculous meningitis (22.5%), cryptococcal meningitis (22.2%)\r\nand bacterial meningitis (6.9%). HIV-encephalopathy, primary central nervous system (CNS) lymphoma and\r\nprogressive multifocal leukoencephalopathy were rare in our patients. CD4 count was done in 64.6% and 89.7%\r\nhad count below 200/mm3[mean = 95.8, median = 57] and 95.7% were stage IV. Neuroimaging was done in 38%\r\nand 56.8% had mass lesion. The overall mortality was 45% and the case-fatality rates were: tuberculous meningitis\r\n(53.8%), cryptococcal meningitis (48.1%), cerebral toxoplasmosiss (44.1%) and bacterial meningitis (33.3%). Change\r\nin sensorium and seizure were predictors of mortality.\r\nConclusions: CNS opportunistic infections were the major causes of neurological manifestations of HIV/AIDS and\r\nwere associated with high mortality and morbidity. Almost all patients had advanced HIV disease at presentation.\r\nEarly diagnosis of HIV, prophylaxis and treatment of opportunistic infections, timely ART, and improving laboratory\r\nservices are recommended. Mortality was related to change in sensorium and seizure.
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