ArticleVirology journal2025
Neurological manifestations in HIV-infected patients: a retrospective cohort study in Northeastern Iran.
Article in Virology journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNeurological complications are a severe aspect of HIV infection, impacting patient outcomes significantly. This study investigates the prevalence and types of neurological syndromes among HIV-infected patients and their outcomes in northeastern Iran.
objectiveTo evaluate the prevalence and types of neurological syndromes in HIV-infected patients, assess predictors of mortality, and compare survival rates between those with neurological versus non-neurological conditions.
methodsA retrospective cohort study was conducted at major referral centers in northeastern Iran from 2011 to 2021. The study included adult HIV-infected patients admitted to the hospitals. Neurological diagnoses were categorized into central nervous system (CNS) involvement, peripheral nervous system involvement, and further categorized.
resultsThe cohort comprised 173 patients with a median age of 40 years (interquartile range, 33-46.8). Neurological syndromes were observed in 22.7% of admissions, with CNS involvement being predominant (93.3%). Neurological complications included primary HIV-associated syndromes (11.6%), infections (33.3%), autoimmune disorders (3.3%), vascular phenomena (3.3%), and neoplasms (1.7%). The in-hospital mortality rate was 22.9%, increasing to 35.6% among patients admitted with neurological syndromes as the primary cause of hospitalization. Significant mortality predictors included male sex (p < 0.001; OR: 3.95, 95% CI: 2.21-7.05), intravenous drug use (p: 0.018; OR: 2.22, 95% CI: 1.18-4.18), neurological syndromes (p = 0.023; OR = 2.07, 95% CI: 1.11-3.86), and altered consciousness (p = 0.004; OR = 3.31, 95% CI: 1.49-7.33). Kaplan-Meier survival curves demonstrate a continuous decline in survival rates since hospital admission, with a 36-month survival rate dropping to 36.3%. Survival rates for patients with neurological syndromes were significantly lower compared to those with other conditions (log-rank p = 0.008). 17.24% of deaths in those with neurological syndromes occurred within 24 h of admission.
conclusionThis study highlights the significant burden of neurological complications among HIV-infected patients, with a notable impact on mortality rates. Neurological infectious diseases accounted for one-third of neurological syndromes among HIV-infected patients. The identified predictors of mortality provide critical insights for healthcare providers, emphasizing the importance of early intervention strategies. Given the high rates of early in-hospital mortality associated with neurological syndromes, there is a need for enhanced monitoring and tailored therapeutic approaches for this vulnerable population.
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