Central and Peripheral Neurological Manifestations during Human Immunodeficiency Virus Infection at the Fann National Hospital in Dakar (Senegal)

Abstract

Introduction: Neurological manifestations associated with HIV are frequent, with variable clinical signs. The aim of our study was to characterize the epidemiological, clinical, paraclinical, therapeutic, evolutionary and prognostic aspects of neurological disorders in HIV.  Methods: This was a descriptive, retrospective and prospective study, from 01 October 2020 to 31 October 2022, conducted in the neurology and infectious and tropical diseases departments of Fann National University Hospital Center (FNUHC) in Dakar (Senegal). Results: We enrolled 93 patients, 56 of whom were women, i.e. a sex ratio of 1.51. The mean age of the patients was 41 years [18 - 73 years]. The onset of clinical signs was predominantly acute (75%). Headache and confusion were the most common neurological signs, 65% and 57% respectively. Meningoencephalitis was the most common central manifestation (91%), followed by mononeuropathy (19%). The average length of hospitalization was 17.92 days [1 - 78 days] and 20 patients (22%) were put on antiretroviral treatment with an average delay of 32.8 days. Corticosteroid therapy was initiated in 58 patients (62%). Forty-seven patients (51%) died during hospitalization and 46 patients (49%) were followed up. Twenty-nine patients (31%) had a favorable outcome with complete disappearance of signs, and the remaining 17 patients (18%) had neurological sequelae. Conclusion: During the course of HIV/AIDS infection, morbidity, mortality and neurological damage remain high. Systematic screening for these neurological signs during follow-up of patients living with HIV is necessary in order to improve diagnostic and therapeutic management.