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AIDS Research and Treatment
Volume 2013, Article ID 709810, 6 pages
http://dx.doi.org/10.1155/2013/709810
Research Article

HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study

1Department of Internal Medicine, Douala General Hospital, P.O. Box 4856, Douala, Cameroon
2Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
3Université des Montagnes, Bangangte, Cameroon
4Faculty of Medicines and Pharmaceutical Sciences, University of Douala, Douala, Cameroon
5Yaoundé Central Hospital, Yaoundé, Cameroon

Received 9 November 2012; Revised 22 January 2013; Accepted 22 January 2013

Academic Editor: D. A. Katzenstein

Copyright © 2013 Henry Namme Luma et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Studies on HIV-associated central nervous system (CNS) diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and December 31, 2009, we did at the Douala General Hospital a clinical case note review of 672 admitted adult (age ≥ 18 years) HIV-1 patients, and 44.6% (300/672) of whom were diagnosed and treated for HIV-associated CNS disease. Results. The mean age of the study population was years, and median CD4 count was 49 cells/mm3 (interquartile range (QR): 17–90). The most common clinical presentations were headache (83%), focal signs (40.6%), and fever (37.7%). Toxoplasma encephalitis and cryptococcal meningitis were the leading aetiologies of HIV-associated CNS disease in 32.3% and 25% of patients, respectively. Overall mortality was 49%. Primary central nervous system lymphoma (PCNSL) and bacterial meningitis had the highest case fatality rates of 100% followed by tuberculous meningitis (79.8%). Low CD4 count was an independent predictor of fatality (AOR: 3.2, 95%CI: 2.0–5.2). Conclusions. HIV-associated CNS disease is common in Douala. CNS symptoms in HIV patients need urgent investigation because of their association with diseases of high case fatality.