Abstract
Background and purpose: Data describing the incidence and survival of HIV-related central nervous system diseases (CNS-D) in recent years are sparse.
Methods: Between 1996 and 2007, adult subjects without previous CNS-D within a large UK cohort were included (n = 30 954). CNS-D were HIV encephalopathy (HIVe), progressive multifocal leucoencephalopathy (PML), cerebral toxoplasmosis (TOXO) and cryptococcal meningitis (CRYP). Associations between demographic, clinical and laboratory parameters with incidence and survival of CNS-D were evaluated using Poisson regression analysis and Kaplan-Meier techniques.
Results: Six hundred and thirteen new CNS-D occurred in 574 subjects (HIVe: 187, PML: 113, TOXO: 184, CRYP: 129). Incidence of all CNS-D declined from 13.1 per 1000 PY in 1996/1997 to 1.0 per 1000 PY in 2006/2007 (P = 0.0001). Current CD4+ cell count below 200 cells/ul and plasma HIV RNA above 100 000 copies/ml were independently associated with the development of CNS-D. Calendar year 1996/1997, older age, prior AIDS diagnosis and PML diagnosis were significantly associated with shorter survival.
Conclusions: An ongoing decline in the incidence of CNS-D has been observed in very recent years. Mortality following such a diagnosis remains high.
Original language | English |
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Pages (from-to) | 527-534 |
Number of pages | 8 |
Journal | European Journal of Neurology |
Volume | 18 |
Issue number | 3 |
DOIs | |
Publication status | Published - Mar 2011 |
Keywords / Materials (for Non-textual outputs)
- INFECTED PATIENTS
- RISK-FACTORS
- ILLNESS
- human immunodeficiency virus
- SURVIVAL
- MULTICENTER AIDS COHORT
- INDIVIDUALS
- epidemiology
- PREVALENCE
- PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY
- NEUROCOGNITIVE IMPAIRMENT
- cohort study