ArticleFrontiers in neurology
Pathogenic characteristics of central nervous system infections in AIDS individuals: a retrospective cohort study based on immune status.
Article in Frontiers in neurology. 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
Background: Human immunodeficiency virus (HIV) infection frequently leads to central nervous system (CNS) complications, especially as immunity declines. While antiretroviral therapy (ART) has transformed HIV into a manageable condition, in clinical practice, a significant subset of individuals still present with advanced immunosuppression (CD4 < 200 cells/μL) due to delayed diagnosis, treatment failure, or poor adherence, leading to AIDS-defining conditions. This study investigated how immune status affects CNS infection characteristics and outcomes specifically within this immunocompromised spectrum of AIDS individuals, aiming to provide refined evidence for risk stratification and early intervention in late-presenting or treatment-experienced individuals. Methods: We retrospectively analyzed 213 individuals with AIDS who presented with CNS symptoms and confirmed CNS infections. They were grouped by CD4 count: 101 with ≥200 cells/μL (Moderate to High Immune, HI) and 112 with <200 cells/μL (Low Immune, LI). We compared symptoms, cerebrospinal fluid (CSF) findings, imaging results, detected pathogens, treatment outcomes, and quality of life between groups. Results: Individuals with low CD4 counts showed significantly more severe symptoms like altered consciousness (50.00% vs. 31.68%, Conclusion: This study quantifies the severe impact of advanced immunosuppression (CD4 < 200 cells/μL) on CNS infection presentation, short-term treatment response (for CNS infections), and quality of life at discharge. Preventing immune decline below this threshold is critical.
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