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• W2969222799 endingPage "1953" @default.
• W2969222799 startingPage "1953" @default.
• W2969222799 abstract "Background: Neurological disorders in HIV infection are a common cause of morbidity and mortality. The aim of this paper is to provide a narrative overview of up to date information concerning neurological disorders affecting HIV infected persons in Africa.Methods: Seminal research concerning neurological disorders among HIV-infected adults in sub-Saharan Africa from prior to 2000 was combined with an in-depth search of PubMed to identify literature published from 2000 to 2017. The following Mesh terms were used. Nervous System Diseases” HIV Infections and Africa South of the Sahara and Seizures or Spinal Cord Diseases or “Peripheral Nervous System Diseases or AIDS Dementia Complex or “Opportunistic Infections or Immune constitution Inflammatory Syndrome” or Stroke. Only those articles written in English were used. A total of 352 articles were identified, selected and reviewed and 180 were included in the study. These included case series, observational studies, interventional studies, guidelines and reviews with metanalyses. The author also included 15 publications on the subject covering theearlier phase of the HIV epidemic in Africa from 1987 to 1999 making a total of 195 references in the study. This was combined with extensive personal experience diagnosing and treating these neurological disorders.Results: Neurological disorders were common, typically occurring in WHO stages III/IV. These were in three main categories: those arising from opportunistic processes mostly infections, direct HIV infection and autoimmunity. The most common were those arising from direct HIV infection occurring in >50%. These included HIV-associated neurocognitive dysfunction (HAND), neuropathy and myelopathy. Opportunistic infections occurred in >20% and frequently had a 6-9-month mortality rate of 60-70%. The main causes were cryptococcus, tuberculosis, toxoplasmosis and acute bacterial meningitis. Concurrentsystemic tuberculosis occurred in almost 50%.Conclusion: Neurological disorders are common in HIV in Africa and the main CNS opportunistic infections result in high mortality rates. Strategies aimed at reducing their high burden, morbidity and mortality include early HIV diagnosis and anti-retroviral therapy (ART), screening and chemoprophylaxis of main opportunistic infections, improved clinical diagnosis and management and programme strengthening.Keywords: Neurological disorders, HIV, Africa, opportunistic infections, direct HIV infection and inflammatory disorders." @default.
• W2969222799 created "2019-08-29" @default.
• W2969222799 creator A5015135863 @default.
• W2969222799 date "2019-08-20" @default.
• W2969222799 modified "2023-10-15" @default.
• W2969222799 title "Neurological disorders in HIV in Africa: a review" @default.
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