Opportunistic diseases as the cause of damage to the central nervous system in patientswith HIV-infection
Objective. To study the clinical manifestations of CNS lesions caused by different factors in patients with HIV disease progression. Materials and methods. The study involved 128 ART naïve HIV patients with CD4 cell counts <350 cells/mcL. These patients were divided into two groups: Group 1 (main group) consisted of 63 patients with clinical features of CNS involvement and Group 2 (control group) consisted with 65 patients without clinical features of CNS involvement (65). We analyzed the data of clinical, laboratory and instrumental parameters and neuropsychiatric status. Results. In the main study group the most commonly diagnosed CNS disorders were HIV encephalitis in 29 cases (46.0%), cerebral toxoplasmosis in 18 cases (28,6%); fungal infection of the CNS in 10 cases (17,2%), HSV infection in 14 cases (22%). In 28,6% of cases CNS lesions were caused by mixed infection. On average, the CSF HIV RNA level in the main group was 13,2 times higher than in the control group. The HIV RNA levels were higher in plasma than CSF. Conclusion: We determined the most common causes of CNS involvement in HIV patients (HIV, toxoplasmosis, fungal infections, HSV). This study shows the feasibility of CSF testing for HIV RNA load and opportunistic infections in HIV patients with advanced immunosuppression.