Neurological complications in patients with Human Immunodeficiency Virus infection at the Japanese Hospital in Santa Cruz, Bolivia
DOI:
https://doi.org/10.56294/ri202525Keywords:
Neurological complications, Human Immunodeficiency Virus infection, Focal Neurological Syndrome, Meningeal SyndromeAbstract
Introduction: Neurological involvement is common among patients with Human Immunodeficiency Virus (HIV) infection. Between 40 and 60% will develop symptomatic neurological complications with high morbidity and mortality at some point. Objective: To analyze the clinical-epidemiological characteristics of patients with HIV infection who develop neurological complications at the Japanese Hospital of Santa Cruz de la Sierra in the period between March 2019 and February 2022.
Methods: Observational, descriptive, prospective, cross-sectional study. Universe and Sample: Patients admitted through the Emergency Service of the Japanese Hospital with a confirmed diagnosis of Human Immunodeficiency Virus Disease during the period between March 2019 and February 2022
Results and discussion: A total of 42 patients were evaluated, the majority of whom were men and had a younger average age. For both sexes, the majority of patients reported having a source of employment. Regarding sexual orientation, almost all women reported being heterosexual, while men were more variable, with the majority being bisexual. Three clinical syndromes were identified at admission. The frequency of focal syndrome was dominant in women, but was not significantly different from the others. In men, meningeal syndrome and focal syndrome were the dominant ones, significantly exceeding non-focal syndrome. Ten neurological complications were identified, cerebral toxoplasmosis was the most frequent, followed by cerebral cryptococcosis and meningeal tuberculosis. Considering all patients in general, their typical hospital stay was 11 days with a range between 2 and 56 days. Of the 42 patients evaluated, it was only possible to measure the CD4 status for 27.
Conclusions: The young male population with employment in the city of Santa Cruz with aberrant sexual behavior was the most affected. Focal syndrome was the most frequent form of presentation, in the form of cerebral toxoplasmosis. Severely low levels of immunosuppression were found in the study population. Hospital stay is variable and is longer in cases of focal syndrome and meningeal syndrome. We consider it important to continue the present study, which will allow us to increase the sample size.
References
1. ONU/SIDA. Hoja Informativa. Últimas estadísticas sobre el estado de la epidemia de sida, 2020. Disponible en: http://www.unaids.org/es/resources/fact-sheet
2. Thakur KT, Boubour A, Saylor D, Das M, Bearden DR, Birbeck GL. Neurología mundial del VIH: una revisión exhaustiva. SIDA [Internet]. 2019;33(2):163–84. Disponible en: http://dx.doi.org/10.1097/QAD.0000000000001796
3. Programa Nacional ITS/VIH/SIDA-HV. Situación del VIH/SIDA en Bolivia Al 31 de marzo de 2021. Disponible en:
https://www.idhbolivia.org/images/Estadisticas/ResEpidVIH-Abril2021.pdf
4. Paruk HF, Bhigjee AI. Revisión de los aspectos neurológicos de la infección por VIH. J Neurol Sci [Internet]. 2021;425(117453):117453. Disponible en: http://dx.doi.org/10.1016/j.jns.2021.117453
5. Fauci A, Lane H, Harrison T, Fauci A, Braunwald E, Kasper D, et al. Enfermedades por el virus de la inmunodeficiencia humana: SIDA y procesos relacionados. En: Harrison T, Fauci A, Braunwald E, Kasper D, editores. Principios de Medicina Interna. 17.ª ed. Madrid: McGraw-Hill; 2009. p. 1685-7.
6. Sionean, Catlainn et al. “HIV Risk, prevention, and testing behaviors among heterosexuals at increased risk for HIV infection--National HIV Behavioral Surveillance System, 21 U.S. cities, 2010.” Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) vol. 63,14 (2014): 1-39. Available at: https://pubmed.ncbi.nlm.nih.gov/25522191/
7. Beer L, Tie Y, Wu K, Luo Q, Crim SM, Mcmanus T, et al. informe especial de vigilancia del VIH publicado por la rama de vigilancia conductual y clínica de la división de prevención del VIH/SIDA, Centro Nacional para la Prevención del VIH/SIDA, Hepatitis Viral, ETS y Tuberculosis, Centros para el Control y la Prevención de Enfermedades (CDC) [Internet ]. cdc.gov. [citado el 13 de febrero de 2022]. Disponible en:
8. Ministerio de Salud. Diagnóstico de infección por virus de la inmunodeficiencia Humana. Bolivia 2014. Guía de Terapia Antirretroviral en adolescentes y adultos. Bolivia. Disponible en: www.sns.gov.bo/its-vih-sida.
9. Grill MF. Neurologic complications of human immunodeficiency virus. Continuum (Minneap Minn) [Internet]. 2021;27(4):963–91. Available at: http://dx.doi.org/10.1212/CON.0000000000001035
10. Howlett WP. Neurological disorders in HIV in Africa: a review. Afr Health Sci [Internet]. 2019;19(2):1953–77. Disponible en: http://dx.doi.org/10.4314/ahs.v19i2.19
11. Dai L, Mahajan SD, Guo C, Zhang T, Wang W, Li T, et al. Spectrum of central nervous system disorders in hospitalized HIV/AIDS patients (2009-2011) at a major HIV/AIDS referral center in Beijing, China. J Neurol Sci [Internet]. 2014;342(1–2):88–92. Disponible en: http://dx.doi.org/10.1016/j.jns.2014.04.031
12. Koralnik I. Abordaje del paciente con VIH y lesiones del sistema nervioso central [Internet]. 2021 [citado 20 de diciembre de 2024]. Disponible en: https://www.uptodate.com/contents/approach-to-the-patient-with-hiv-and-central-nervous-system-lesions?csi=a5af8953-780f-4066-aa2f06e4c4180e85&source=contentShare
13. Uwishema O, Ayoub G, Badri R, Onyeaka H, Berjaoui C, Karabulut E, et al. Trastornos neurológicos en el VIH: esperanza a pesar de los desafíos. Immun Inflamm Dis [Internet]. 2022; Disponible en: http://dx.doi.org/10.1002/iid3.591
14. Levy RM, Bredesen DE, Rosenblum ML. Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. J Neurosurg [Internet]. 1985;62(4):475–95. Disponible en: http://dx.doi.org/10.3171/jns.1985.62.4.0475
15. Kouakou GA, Ello NF, Kassi NA, Keita M, Doumbia A, Mossou C, et al. Fluconazole 1200 mg ou 800 mg dans le traitement de la cryptococcose neuroméningée en Côte d’Ivoire. J Mycol Med [Internet]. 2017;27(1):72–8. Disponible en: http://dx.doi.org/10.1016/j.mycmed.2016.10.001
16. Directrices Sociedad de Enfermedades Infecciosas de América. Directrices de atención primaria para el tratamiento de personas infectadas por el VIH: actualización de 2013 de la Asociación de Medicamentos contra el VIH. Clin Infect Dis. 2014;58(1):1-10.
17. Marion DW. Pacing the digm: Patient selection, evaluation, implantation, and complications [Internet]. En: Post TW, editor. UpToDaphraate. Waltham, MA: UpToDate; [citado 20 de enero de 2022]. Disponible en: https://www.uptodate.com
18. Silva Reyes I, Del Campo Mulet E, Nápoles Smith N, Cuba García M, Arias Deroncerés IJ. Aspectos clinicoepidemiológicos en pacientes con coinfección por sida y tuberculosis en la provincia de Santiago de Cuba. MEDISAN [Internet]. 2016 [citado 20 de diciembre de 2024];20(10). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30192016001000010
19. Ministerio de Salud Pública. Infección por el virus de la inmunodeficiencia humana (VIH-SIDA): Guías para diagnóstico, tratamiento antirretroviral y monitorización en adultos y embarazadas [Internet]. 2018 [citado 20 de diciembre de 2024]. Disponible en: www.who.int/hiv/pub/guidelines/uruguay_art.pdf
20. Ben-Shachar, M., D. Lüdecke & D. Makowski. 2020. effectsize: Estimation of Effect Size Indices and Standardized Parameters. Journal of Open Source Software 5(56): 2815.
21. Salvatierra-Rocha CJ, Auza-Santivañez JC, Flores Yucra G, Bastos-Vargas CP, Vallejos-Rejas DRE, Santander Oberson I, et al. Psychiatric disorders in patients with epilepsy in the Japanese Hospital and the Dr. Mario Ortíz Suárez Children’s Hospital of Santa Cruz, Bolivia. Multidisciplinar (Montevideo) [Internet]. 2024 Aug. 15 [cited 2024 Dec. 20];2:87. Available from: https://multidisciplinar.ageditor.uy/index.php/multidisciplinar/article/view/87
22. Cohen, J. 1988. Statistical Power Analysis for the Behavioral Sciences. 2 edition, Hillsdale: Lawrence Erlbaum. 579 p.
23. Field, A. 2013. Discovering statistics using IBM SPSS Statistics. Fourth Edition. Sage: London.
24. Funder D, Ozer D. Evaluating effect size in psychological research: Sense and nonsense. Adv Methods Pract Psychol Sci. 2019;2(2):156-68. Available from: https://doi.org/10.1177/2515245919847202
25. Glass, G.V. 1966. Note on rank biserial correlation. Educational and Psychological Measurement 26: 622-631.
26. Makowski, D., M.S. Ben-Shachar, I. Patil & D. Lüdecke. 2020. Automated Results Reporting as a Practical Tool to Improve Reproducibility and Methodological Best Practices Adoption. CRAN. Available from: https://github.com/easystats/report
27. Márquez Molina J, Auza Santivañez JC, Cruz Choquetopa E, Antezana Muñoz JB, Arteaga Iriarte O, Fernández Burgoa H. Early prediction of acute kidney injury in neurocritical patients: relevance of renal resistance index and intrarenal venous Doppler as diagnostic tools. Data and Metadata [Internet]. 2023 Apr. 7 [cited 2024 Dec. 20];2:30. Available from: https://dm.ageditor.ar/index.php/dm/article/view/175 .
28. Patil, I. 2021. Visualizations with statistical details: The 'ggstatsplot' approach. Journal of Open Source Software 6(61): 3167, doi:10.21105/joss.03167.
Published
Issue
Section
License
Copyright (c) 2025 Carmen Julia Salvatierra-Rocha, Jhossmar Cristians Auza-Santivañez, Alejandro Peralta Landívar, Carlos Lá Fuente Zerain, Mildred Ericka Kubatz La Madrid, Yamila Cruz Cruz, Paul Cardozo Gil, Marco Antonio Gumucio Villarroel, Dulce María Hernández Vázquez (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
The article is distributed under the Creative Commons Attribution 4.0 License. Unless otherwise stated, associated published material is distributed under the same licence.
