Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature
Neurological disorders caused by Cytomegalovirus (CMV) in patients with Acquired Immunodeficiency Syndrome (AIDS) are rarely reported in the Highly Active Antiretroviral Therapy (HAART) period. The objective of this study was to describe the main clinical and laboratory features of patients with CMV...
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Universidade de São Paulo (USP)
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ftdoajarticles:oai:doaj.org/article:daa6672cd47e491aa46e7ed95cad2fe5 2024-09-09T19:28:00+00:00 Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature Camila Almeida Silva Augusto C. Penalva de Oliveira Lucy Vilas-Boas Maria Cristina D.S. Fink Cláudio S. Pannuti José E. Vidal 2010-12-01T00:00:00Z https://doi.org/10.1590/S0036-46652010000600004 https://doaj.org/article/daa6672cd47e491aa46e7ed95cad2fe5 EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652010000600004&lng=en&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/S0036-46652010000600004 https://doaj.org/article/daa6672cd47e491aa46e7ed95cad2fe5 Revista do Instituto de Medicina Tropical de São Paulo, Vol 52, Iss 6, Pp 305-310 (2010) Human immunodeficiency virus AIDS Cytomegalovirus Encephalitis Polyradiculopathy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2010 ftdoajarticles https://doi.org/10.1590/S0036-46652010000600004 2024-08-05T17:49:30Z Neurological disorders caused by Cytomegalovirus (CMV) in patients with Acquired Immunodeficiency Syndrome (AIDS) are rarely reported in the Highly Active Antiretroviral Therapy (HAART) period. The objective of this study was to describe the main clinical and laboratory features of patients with CMV-related neurological complications in HIV-infected patients admitted to a referral center in São Paulo, Brazil. CMV disease requires the identification of the virus in the cerebrospinal fluid (CSF) using Polymerase Chain Reaction (PCR). Thirteen cases were identified between January, 2004 and December, 2008. The median age of patients was 38 years and nine (69%) were men. At admission all patients were aware of their HIV status and only four (31%) patients were on HAART. Patients who were not on antiretroviral therapy before admission received HAART while inpatients. CMV disease was the first AIDS-defining illness in eight (62%) patients. The neurologic syndromes identified were diffuse encephalitis (n = 7; 62%), polyradiculopathy (n = 7; 54%), focal encephalitis (rhombencephalitis) (n = 1; 8%), and ventriculo-encephalitis (n = 1; 8%). Seven (54%) patients presented extra-neural CMV disease and four (31%) had retinitis. The median of CD4+ T-cell count was 13 cells/µL (range: 1-124 cells/µL). Overall in-hospital mortality was 38%. Eight patients used ganciclovir or foscarnet (in-hospital mortality: 50%) and five patients used ganciclovir and foscarnet (in-hospital mortality: 20%). None of the patients fulfilled the diagnosis criteria of immune reconstitution inflammatory syndrome. Four patients were lost to follow-up, and three patients presented immune recovery and discontinued secondary prophylaxis. Although infrequent, distinct neurological syndromes caused by CMV continue to cause high mortality among AIDS patients. Survival depends upon the use of effective antiviral therapy against CMV and the early introduction of HAART. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista do Instituto de Medicina Tropical de São Paulo 52 6 305 310 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Human immunodeficiency virus AIDS Cytomegalovirus Encephalitis Polyradiculopathy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Human immunodeficiency virus AIDS Cytomegalovirus Encephalitis Polyradiculopathy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Camila Almeida Silva Augusto C. Penalva de Oliveira Lucy Vilas-Boas Maria Cristina D.S. Fink Cláudio S. Pannuti José E. Vidal Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature |
topic_facet |
Human immunodeficiency virus AIDS Cytomegalovirus Encephalitis Polyradiculopathy Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Neurological disorders caused by Cytomegalovirus (CMV) in patients with Acquired Immunodeficiency Syndrome (AIDS) are rarely reported in the Highly Active Antiretroviral Therapy (HAART) period. The objective of this study was to describe the main clinical and laboratory features of patients with CMV-related neurological complications in HIV-infected patients admitted to a referral center in São Paulo, Brazil. CMV disease requires the identification of the virus in the cerebrospinal fluid (CSF) using Polymerase Chain Reaction (PCR). Thirteen cases were identified between January, 2004 and December, 2008. The median age of patients was 38 years and nine (69%) were men. At admission all patients were aware of their HIV status and only four (31%) patients were on HAART. Patients who were not on antiretroviral therapy before admission received HAART while inpatients. CMV disease was the first AIDS-defining illness in eight (62%) patients. The neurologic syndromes identified were diffuse encephalitis (n = 7; 62%), polyradiculopathy (n = 7; 54%), focal encephalitis (rhombencephalitis) (n = 1; 8%), and ventriculo-encephalitis (n = 1; 8%). Seven (54%) patients presented extra-neural CMV disease and four (31%) had retinitis. The median of CD4+ T-cell count was 13 cells/µL (range: 1-124 cells/µL). Overall in-hospital mortality was 38%. Eight patients used ganciclovir or foscarnet (in-hospital mortality: 50%) and five patients used ganciclovir and foscarnet (in-hospital mortality: 20%). None of the patients fulfilled the diagnosis criteria of immune reconstitution inflammatory syndrome. Four patients were lost to follow-up, and three patients presented immune recovery and discontinued secondary prophylaxis. Although infrequent, distinct neurological syndromes caused by CMV continue to cause high mortality among AIDS patients. Survival depends upon the use of effective antiviral therapy against CMV and the early introduction of HAART. |
format |
Article in Journal/Newspaper |
author |
Camila Almeida Silva Augusto C. Penalva de Oliveira Lucy Vilas-Boas Maria Cristina D.S. Fink Cláudio S. Pannuti José E. Vidal |
author_facet |
Camila Almeida Silva Augusto C. Penalva de Oliveira Lucy Vilas-Boas Maria Cristina D.S. Fink Cláudio S. Pannuti José E. Vidal |
author_sort |
Camila Almeida Silva |
title |
Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature |
title_short |
Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature |
title_full |
Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature |
title_fullStr |
Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature |
title_full_unstemmed |
Neurologic cytomegalovirus complications in patients with AIDS: retrospective review of 13 cases and review of the literature |
title_sort |
neurologic cytomegalovirus complications in patients with aids: retrospective review of 13 cases and review of the literature |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2010 |
url |
https://doi.org/10.1590/S0036-46652010000600004 https://doaj.org/article/daa6672cd47e491aa46e7ed95cad2fe5 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 52, Iss 6, Pp 305-310 (2010) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652010000600004&lng=en&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/S0036-46652010000600004 https://doaj.org/article/daa6672cd47e491aa46e7ed95cad2fe5 |
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https://doi.org/10.1590/S0036-46652010000600004 |
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Revista do Instituto de Medicina Tropical de São Paulo |
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52 |
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