HIV-Encephalopathy as initial manifestation of acquired immunodeficiency Syndrome in Yucatلn State, Mexico

Background equency of neurologic manifestations of the central nervous system (CNS) as a defining disease of acquired immunodeficiency syndrome (AIDS) (neurologic manifestation defining disease [NMDD-AIDS]) varies according to geographic region. The aim of this study was to determine its prevalence among patients with AIDS diagnosed in the state of Yucatán, Mexico. s ried out a retrospective study in which AIDS cases reported at the Health Department in the state of Yucatán, Mexico from January 1983 to July 2001 were analyzed. Frequency of NMDD-AIDS and other pathologies were obtained. Frequency of other pathologies between patients with NMDD-AIDS and those without NMDD-AIDS was compared using χ2 and/or Fisher exact test. s l of 1,175 subjects (1,054 [90%] men and 121 [10%] women) were included in the study. In 186 (16%), NMDD-AIDS were observed. The most common NMDD-AIDS was HIV-encephalopathy in 101 (54%) patients, CNS toxoplasmosis in 65 (35%), meningeal cryptococosis in 16 (8.6%), primary lymphoma of the brain in two (1%), and one (0.5%) case of progressive multifocal leukoencephalopathy. CD4 lymphocytes were statistically different between patients with NMDD-AIDS (n = 47) and without (n = 312) (mean: 65/μL (33–500) vs. 189/μL (2–989), p<0.005). Higher frequency of oropharyngeal candidiasis, pulmonary tuberculosis, herpetic stomatitis, and mortality was observed in patients with initial neurologic disease. sions ncy of NMDD-AIDS was similar to some reports from the U.S. but lower than others from Mexico. HIV-encephalopathy was the most frequent manifestation. NMDD-AIDS were associated with advanced stage of immunodeficiency and influenced morbidity and mortality associated with AIDS.