Obiako O R, Ogoina D, Abubakar S A, Muktar H M, Sheikh T L, Tabi-Ajayi E, Kehinde J A, Iwuozo E U, Musa B O P
Department of Medicine1, HIV Treatment Centre2 , Ahmadu Bello University Teaching Hospital (ABUTH) Shika Zaria, Nigeria.
Niger Postgrad Med J. 2014 Dec;21(4):319-26.
Highly active antiretroviral therapy (HAART) has been shown to reduce AIDS- defining illnesses, including neuropathies. However, it has been postulated that an increase in age -, HIV- and HAART- related neurological complications will occur as HIV-infected persons live longer. This study investigated the frequency and outcome of neuropathies in relation to CD4+ cell count and HAART status of hospitalised HIV/AIDS patients in Shika.
Consecutive adult (e"15 years) non pregnant HIV- infected patients treated at Ahmadu Bello University Teaching Hospital Shika-Zaria from January 2006 to May 2013 with neuropathies were studied. Non HIV-infected patients with neurological disorders and HIV-infected patients without neuropathies were excluded.
Of 5240 HIV/AIDS patients seen , 11% (566) presented with neuropathy at median CD4+ cell counts of 200 cells / ul, with yearly reduction of the frequency of patients with neuropathy from 3.9% in 2006 to 0.06% in 2013. Male: female ratio was 2:1 and respective mean years were 41.9±10.1: 45.3±17.4 (p<0.00). 253 (45%) were on HAART at presentation. 40 patients died and the mortality was associated with recurrent seizures, CD4+ cell counts d" 100 / ul, male sex, HAART-naivety and presence of co-morbidity and complications.
The progressive reduction in the yearly frequency of neuropathy among HIV/AIDS patients suggests a beneficial effect of HAART on neuropathies. However, late presentation, low CD4+ cell counts and failure of patients to start HAART early were responsible for AIDS-related mortality thus highlighting the importance of early HIV screening and treatment.
高效抗逆转录病毒疗法（HAART）已被证明可减少包括神经病变在内的艾滋病界定疾病。然而，据推测，随着感染艾滋病毒的人寿命延长，与年龄、艾滋病毒和HAART相关的神经并发症将会增加。本研究调查了希卡地区住院的艾滋病毒/艾滋病患者神经病变的发生率及转归与CD4 +细胞计数和HAART状态的关系。
对2006年1月至2013年5月在阿马杜·贝洛大学教学医院希卡-扎里亚接受治疗的患有神经病变的连续成年（≥15岁）非妊娠艾滋病毒感染患者进行研究。排除患有神经系统疾病的非艾滋病毒感染患者和没有神经病变的艾滋病毒感染患者。
在5240例就诊的艾滋病毒/艾滋病患者中，11%（566例）在CD4 +细胞计数中位数为200个/微升时出现神经病变，神经病变患者的发生率从2006年的3.9%逐年下降至2013年的0.06%。男女比例为2:1，各自的平均年龄分别为41.9±10.1岁：45.3±17.4岁（p<0.00）。253例（45%）就诊时正在接受HAART治疗。40例患者死亡，死亡率与癫痫复发、CD4 +细胞计数≤100个/微升、男性、未接受过HAART治疗以及合并症和并发症的存在有关。
艾滋病毒/艾滋病患者神经病变的年发生率逐渐降低，提示HAART对神经病变有有益作用。然而，就诊延迟、CD4 +细胞计数低以及患者未早期开始HAART治疗是艾滋病相关死亡的原因，因此突出了早期艾滋病毒筛查和治疗的重要性。
