NEUROEPIDEMIOLOGY OF ACQUIRED IMMUNODEFICIENCY SYNDROME

Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

NEUROEPIDEMIOLOGY OF ACQUIRED IMMUNODEFICIENCY SYNDROME

AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 13-27, 1988.. Unique Identifier : AIDSLINE ICDB/89648461
Levy RM; Janssen RS; Bush TJ; Rosenblum ML; Dept. of Neurosurgery, Northwestern Univ. Medical Sch., 707; Fairbanks Court, Suite 811, Chicago, IL 60611

Abstract: Three approaches were used to better characterize the epidemiology of CNS complications of AIDS in the United States: (1) evaluation of Centers for Disease Control (CDC) data on specific CNS diseases in terms of geographic region, risk group, T-cell ratio, serological evidence of infection with HIV, and AIDS-related neurological diseases; (2) evaluation of available data from all patients (pts) with AIDS treated at the hospitals affiliated with the University of California, San Francisco (UCSF), for evidence of nervous system involvement; and (3) performance of postmortem examination on all pts at UCSF who died of AIDS from 1980 through June 1986. CNS complications reported here are cryptococcal meningitis, toxoplasmosis, progressive multifocal leukoencephalopathy (PML), and primary CNS lymphoma. Analysis of the CDC data suggests that toxoplasmosis occurs most frequently in Florida, in both Haitian and non-Haitian AIDS pts. In general, Haitian AIDS pts are more frequently reported to have CNS complications than are pts in other risk groups. Cryptococcal meningitis is reported most frequently in New Jersey, possibly because of the higher percentage of AIDS pts in that state who are black or iv drug abusers. PML and primary CNS lymphomas do not appear to preferentially affect any single risk group or geographic region. In 1286 AIDS pts examined at UCSF, almost all of whom were homosexual or bisexual men, the incidence of the four CNS diseases specifically reportable to the CDC was 4.6% at presentation, reflecting the lower frequency of neurological illness in homosexuals with AIDS than in other risk groups. Nevertheless, 37% of the pts studied developed some neurological illness, of which HIV encephalopathy was the most frequent. Postmortem neuropathological examination of 94 pts at UCSF revealed CNS disease in 74% of them. (15 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY/ MORTALITY Adult Brain Neoplasms/EPIDEMIOLOGY/ETIOLOGY Central Nervous System Diseases/EPIDEMIOLOGY/*ETIOLOGY/MORTALITY Child Cross-Sectional Studies Cryptococcosis/EPIDEMIOLOGY/ETIOLOGY Human Leukoencephalopathy, Progressive Multifocal/EPIDEMIOLOGY/ETIOLOGY Lymphoma/EPIDEMIOLOGY/ETIOLOGY Meningitis/EPIDEMIOLOGY/ETIOLOGY Opportunistic Infections/EPIDEMIOLOGY/ETIOLOGY Risk Factors Toxoplasmosis/EPIDEMIOLOGY/ETIOLOGY United States MONOGRAPH

890228
M8920519

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