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• W1498545566 abstract "Objective: To determine the etiology of new onset seizure among HIV+ Zambian adults.Background: The risk for recurrent seizures among people in sub-Saharan Africa with HIV/AIDS who experience new onset seizure is unknown.Methods: We conducted a prospective cohort study of HIV-infected adults presenting with new onset seizure to evaluate long-term outcomes including recurrent seizure and death. We enrolled HIV-infected adults presenting with new onset seizure within 2 weeks of their index seizure. We performed CD4, sodium, glucose, malaria RDT, RPR, and extensive cerebrospinal fluid studies to establish an etiology. Patients had serum toxoplasma antibody and cryptococcal antigen testing if they refused lumbar puncture. We obtained neuroimaging on select patients if no etiology was identified based upon the laboratory evaluations.Results: In 22 months, we screened 351 patients and enrolled 95. Patient characteristics were mean age of 35 years, 54 males (57[percnt]), median CD4 111 cells/µl, with 30 (32[percnt]) on cART. We performed CSF PCR on 61 patients. Findings included 17 (28[percnt]) EBV, 4 (7[percnt]) JCV and 3 (5[percnt]) each for MTB, VZV, and CMV DNA. We identified 13 (14[percnt]) cases of cryptococcal meningitis through either India Ink or CrAg testing of CSF specimens. There were 12 (20[percnt]) cases where multiple pathogens were present in a patient’s CSF in varying combinations. Additionally, 5 (6[percnt]) patients had syphilis and 2 (2[percnt]) malaria parasitemia. There was one case of neurocysticercosis confirmed on neuroimaging. 47 (49[percnt]) were found to be hyponatremic. 9 (10[percnt]) were felt to have probable or possible CNS TB based on a combination of neurological symptoms, active pulmonary TB, CSF biochemistry, neuroimaging, and response to TB treatment. During follow-up, 35 (37[percnt]) patients died.Conclusions: Seizures in HIV-infected adults in Zambia are associated with significant morbidity and mortality. Multiple infectious etiologies and/or metabolic abnormalities account for the majority of cases. Disclosure: Dr. Siddiqi has nothing to disclose. Dr. Elafros has nothing to disclose. Dr. Sikazwe has nothing to disclose. Dr. Bositis has nothing to disclose. Dr. Koralnik has received personal compensation for activities with Johnson & Johnson as a scientific advisory board member. Dr. Koralnik has received personal compensation in an editorial capacity for Annals of Neurology. Dr. Koralnik has received royalt Dr. Potchen has received personal compensation for activities as a medical expert witness. Dr. Theodore held stock and/or stock options in General Electric. Dr. Kalungwana has nothing to disclose. Dr. Birbeck has received research support from the National Institutes of Health, the Dana Foundation, and the AMA Foundation." @default.
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• W1498545566 date "2015-04-06" @default.
• W1498545566 modified "2023-09-26" @default.
• W1498545566 title "Etiologies of New Onset Seizure in HIV-infected Zambian Adults (I7-3A)" @default.
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