Neurological Manifestations in HIV-Positive African American Population

1. Neurological Manifestations in HIV-Positive African American Population Sherita Chapman, Misan Pessu, Elizabeth Chimah, Raza L. Khan, Mohankumar Kurukumbi, Annapurni Jayam-Trouth Department of Neurology, Howard University Hospital, Washington, DC Introduction Results African Americans are disproportionately affected by human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS) at a rate that is 10 times greater than the U.S. white population. Three percent of the District of Columbia (DC) population has HIV infection, which is the highest in the nation. Approximately two-thirds of patients with HIV infection will develop CNS involvement during the course of their disease. Several North American and European studies have reported improved outcomes of major neurological disorders in HIV-infected patients receiving combination antiretroviral therapy, while other studies showed no change in prevalence. Currently, no literature is available regarding the demographics and neurological manifestations in the African American population with HIV infection. Demographic Characteristics Relationship of CD4 count and Neuropsychiatric Manifestations % % Conclusion Demographic Relationship of Neuro-manifestations This study shows that neuropsychiatric disease is the most common neurologic manifestation of HIV infection within the African American population studied with depression as the most common subtype. A relatively higher percentage of patients with neuropsychiatric presentations had CD4 counts > 200. This could indicate that there is a paradigm shift of neurological diseases from opportunistic infections to neuropsychiatric manifestations, and this may be related to longer survival secondary to effective antiretroviral treatment. In addition, a significant percentage of patients reported of a history of drug use. In respect to drug use, there was no significant difference among the percentage of patients with CD4 counts <200 vs. > 200. This could indicate that immune status of HIV patients does not play a role in their behavior (drug abuse). However, a prospective study is needed to confirm these conclusions. Aim To study the prevalence and neurological manifestations associated with HIV in African Americans in the DC metropolitan area. % Design/Method Medical records of 282 consecutive HIV-positive African American patients with concurrent neurological diagnosis admitted in 2010 to Howard University Hospital, Washington, DC were retrospectively reviewed for demographic variables, neurological manifestations in relation to CD4 counts. Relationship of Drug Use on Neuro-manifestations Disclosure Statement % References Dr. Chapman has nothing to disclose. Dr. Khan has nothing to disclose. M. Pessu and E. Chimah has nothing to disclose. Dr. Kurukumbi has nothing to disclose. Dr. Trouth has nothing to disclose. UNAIDS, WHO (December 2007). “2007 AIDS Epidemic update.” “Worldwide AIDS & HIV Statistics.” AVERT. 31 December 2009. Hogg RS, Heath KV, Yip B, et al. Improved survivial among HIV-infected individuals following initiation of antiretroviral therapy. JAMA 1998; 279:450-4.