Neurological complications of HIV: epidemiological, clinical and evolutionary aspects in the neurology department of the national hospital of Pikine (Dakar-Senegal)

Introduction: Neurological complications related to human immunodeficiency virus (HIV) infection can occur at all stages of the disease. Objective: To describe the epidemiological, clinical and evolutionary aspects of patients who have presented neurological complications of HIV followed at the neurology department of the CHN of Pikine. Methodology: This is a cross-sectional study from January 2023 to August 2023 on a population of patients living with HIV followed in the Neurology Department of the National Hospital Center of Pikine. Results: Sixteen patients were collected, including eight men. The average age is 43.75 years old. The most frequent reasons for consultation were fever (68.75%), followed by headache (62.5%) and motor deficit (37.5%). Somatically, pyramidal syndrome was the most common neurological manifestation (62.5%), followed by meningeal syndrome (50%) and delirium syndrome (37.5%). Considering the WHO classification, WHO stage 4 was the most represented clinical stage. It was noted in 8 patients. HIV-1 and HIV-2 positive patients numbered 14 (87.5%) and 1 (6.25%) respectively. A co-infection of HIV1 and 2 was noted in only one patient. The main associated neurological disorders were dominated by viral encephalitis and meningoencephalitis (43.75%), cerebral toxoplasmosis (25%) and neuromeningeal tuberculosis (25%). The CD4 count was available in 11 patients (68.75%), with an average of 227.18 cells/mm3. The CSF biochemical study showed normoglycorachia in 11 patients (68.45%) and hypoglycorachia in 4 patients (25%). The cytology study of the CSF showed normal cellularity in 2 patients, lymphocytic hypercellularity in 12 patients (75%). The CT scan was performed in 11 patients, i.e. 68.8%. It returned normal in 4 patients. The main CT diagnoses were dominated by toxoplasmosis with roundel images (18.75%). Death occurred in 7 patients (43.75%). Conclusion: Neurological complications are frequent and serious during HIV infection. They require early diagnosis and appropriate treatment in order to avoid late treatment responsible for very high mortality. Keywords: Neurological complications, HIV/AIDS, CHN of Pikine.