Infectious lesions of the central nervous system in HIV-positive patients
The study involved 45 HIV-positive patients with infectious lesions of the CNS, hospitalized in the infectious department of City Clinical Hospital №8 of Chelyabinsk for the period 2013-2016. Among patients predominate: unemployed (86,7%) men (77,8%) of young working age (Me=34 years). Median hospitalization - 14 days. For the majority of patients (55,6%) is characterized by an advanced 4 stage of HIV infection. In half the cases (53,3%) the diagnosis «HIV» has been set for the first time. The overwhelming majority of patients (91,1%) needed treatment in an intensive care unit. There was a high incidence of edema-swelling of the brain (73,3%) and high mortality (11,1%). Prevailed serous nature of inflammation (66,7%); one-third of cases (33,3%) was due to secondary septic suppurative inflammation. The tendency for a greater frequency of meningoencephalitis (57,8%). Typical poly etiology of the disease: Mycobacterium - 14 (31,1%); Cryptococcus - 2 (4,4%); Toxoplasma - 1 (2,2%); Streptococcus pneumoniae - 1 (2,2%); Meningococcus - 1 (2,2%); mix (cocci) - 1 (2,2%); unspecified etiology - 25 (55.6%). Most patients (75,6%) at the time of hospitalization were in serious condition, often with an altered level of consciousness (40,0%) and inappropriate behavior (40,0%); to 82,2% were observed pronounced meningeal symptoms. CSF analysis revealed no statistically significant differences depending on the type of inflammation except for the obvious differences in the relative content of neutrophils and lymphocytes. The general analysis of blood marked leukocytosis, due to neutrophil granulocytes, a statistically significantly higher in purulent inflammation. CD4+ cells content in blood was significantly lower when compared serous inflammation purulent, indicating a greater degree of immunosuppression in nature serous inflammation.