Abstract
Background and Objectives: Patients living with HIV (PLWH), especially those diagnosed too late or not receiving treatment with antiretroviral drugs in the stage of advanced immunodeficiency AIDS for various reasons, develop additional opportunistic infections or AIDS-defining diseases that may contribute directly to the death of these patients. Material and Methods: In this work, we focused on disorders of the central nervous system (CNS) by retrospectively analyzing the symptoms, clinical and autopsy diagnoses of patients diagnosed with HIV infection who died in the provincial specialist hospital in the Lower Silesia region in Poland. Results: The autopsy was performed in 27.4% cases. The cause of death was determined to be HIV-related/AIDS-associated in 78% patients. The most common AIDS-defining CNS diseases in our cohort were toxoplasmosis and cryptococcosis. Conslusions: The presented results of the most common causes of changes in the central nervous system among deceased HIV-infected patients are comparable to the results of studies by other scientists cited in the publication.
Highlights
The central nervous system (CNS) is the second-most commonly affected organ system by various manifestations secondary to HIV infection and/or AIDS [1]
The aim of our analysis was to evaluate the characteristics of the group of patients with HIV infection who died during hospitalization at our ward, including the subgroup of patients presenting neurological symptoms during hospitalization, as well as to analyse the causes of death taking into account AIDS-related or non-AIDS-related diseases
A retrospective analysis published by Brazilian researchers yielded similar findings of the most frequent aetiology of CNS lesions based on autopsy reports of 284 HIV-positive patients, identifying them as toxoplasmosis, cryptococcosis, bacterial infection, and HIV encephalitis [19]
Summary
The central nervous system (CNS) is the second-most commonly affected organ system (after the respiratory system) by various manifestations secondary to HIV infection and/or AIDS [1]. The onset of neurological symptoms, or even a suspected CNS pathology in an HIV-positive patient, should prompt a comprehensive diagnostic evaluation for infectious and other (non-infectious) diseases, including those unrelated to HIV infection (see Table 1) [2,3]. All above are the symptoms of CNS pathologies seen mostly in HIV-positive patients and patients with AIDS: toxoplasmosis, cryptococcosis, progressive multifocal leukoencephalopathy (PML), and CNS lymphoma [4]. Material and Methods: In this work, we focused on disorders of the central nervous system (CNS) by retrospectively analyzing the symptoms, clinical and autopsy diagnoses of patients diagnosed with HIV infection who died in the provincial specialist hospital in the Lower Silesia region in Poland. Conslusions: The presented results of the most common causes of changes in the central nervous system among deceased HIV-infected patients are comparable to the results of studies by other scientists cited in the publication
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