Condition Lookup

Acute and Chronic Inflammatory Demyelinating Polyneuropathy in HIV

Category: Central Nervous System Complications in HIV

Symptoms:
progressive muscle weakness; loss of reflexes; tingling or numbness in extremities; difficulty walking; fatigue; autonomic dysfunction in severe cases

Root Cause:
Autoimmune-mediated damage to the myelin sheath of peripheral nerves, likely triggered by HIV-related immune dysregulation.

How it's Diagnosed: videos
Clinical examination, nerve conduction studies, cerebrospinal fluid (CSF) analysis (elevated protein levels with normal cell counts), and MRI to rule out other conditions.

Treatment:
Immunomodulatory therapies such as intravenous immunoglobulin (IVIG), plasmapheresis, and corticosteroids; antiretroviral therapy (ART) to control HIV infection.

Medications:
Treatments include corticosteroids (e.g., prednisone ), intravenous immunoglobulin (immunomodulatory agents), and ART (antiretroviral medications such as integrase inhibitors, protease inhibitors, and NNRTIs).

Prevalence: How common the health condition is within a specific population.
Relatively rare; occurs in a small subset of HIV patients, typically those with advanced immunosuppression.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
Advanced HIV infection, lack of adherence to ART, genetic predisposition to autoimmune responses.

Prognosis: The expected outcome or course of the condition over time.
Variable; early diagnosis and treatment can lead to partial or full recovery, but delayed treatment may result in persistent neurological deficits.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Chronic disability, progression to permanent nerve damage, or secondary infections due to weakened immune system.

Central Nervous System Lymphoma in HIV

Specialty: Infectious Diseases

Category: Central Nervous System Complications in HIV

Symptoms:
headache; seizures; confusion; focal neurological deficits; behavioral changes; vision problems

Root Cause:
Epstein-Barr Virus (EBV)-associated malignancy that occurs due to severe immunosuppression in HIV patients, leading to unregulated B-cell proliferation.

How it's Diagnosed: videos
MRI or CT scan showing mass lesions, CSF cytology for malignant cells, and EBV DNA detection in CSF. Brain biopsy may be needed for definitive diagnosis.

Treatment:
High-dose methotrexate-based chemotherapy combined with ART; corticosteroids to reduce cerebral edema; radiation therapy in selected cases.

Medications:
High-dose methotrexate (antimetabolite chemotherapy), rituximab (monoclonal antibody), and corticosteroids such as dexamethasone (anti-inflammatory).

Prevalence: How common the health condition is within a specific population.
Occurs in approximately 3–5% of HIV patients with advanced immunosuppression.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
CD4 count <50 cells/mm³, untreated or poorly controlled HIV, and EBV infection.

Prognosis: The expected outcome or course of the condition over time.
Poor without treatment; survival improves with ART and aggressive lymphoma treatment but remains limited due to recurrence and systemic complications.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Intracranial pressure, seizures, cognitive impairment, and recurrence of lymphoma.

CNS Cryptococcosis in HIV

Specialty: Infectious Diseases

Category: Central Nervous System Complications in HIV

Symptoms:
headache; fever; nausea; vomiting; stiff neck; photophobia; altered mental status

Root Cause:
Opportunistic fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii in immunocompromised individuals.

How it's Diagnosed: videos
CSF analysis with India ink staining, cryptococcal antigen test, fungal culture, and MRI/CT imaging for associated findings.

Treatment:
Initial treatment with amphotericin B and flucytosine for induction therapy, followed by fluconazole for consolidation and maintenance therapy; concurrent ART for HIV management.

Medications:
Amphotericin B (antifungal polyene), flucytosine (antifungal antimetabolite), fluconazole (azole antifungal).

Prevalence: How common the health condition is within a specific population.
Common in HIV patients with CD4 counts <100 cells/mm³, particularly in resource-limited settings.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
Advanced HIV, environmental exposure to cryptococcal spores, lack of ART adherence.

Prognosis: The expected outcome or course of the condition over time.
High mortality if untreated; with prompt therapy, survival rates improve, though neurological sequelae may persist.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Increased intracranial pressure, hydrocephalus, and long-term cognitive deficits.

CNS Toxoplasmosis in HIV

Specialty: Infectious Diseases

Category: Central Nervous System Complications in HIV

Symptoms:
headache; seizures; confusion; fever; focal neurological deficits; lethargy

Root Cause:
Reactivation of latent infection by Toxoplasma gondii due to profound immunosuppression.

How it's Diagnosed: videos
Brain imaging (MRI or CT) showing ring-enhancing lesions, positive Toxoplasma serology (IgG), and CSF PCR for Toxoplasma gondii DNA.

Treatment:
Combination of pyrimethamine, sulfadiazine, and leucovorin; ART to restore immune function.

Medications:
Pyrimethamine (antiparasitic), sulfadiazine (antibiotic), leucovorin (folinic acid to reduce bone marrow toxicity).

Prevalence: How common the health condition is within a specific population.
Occurs in 10–30% of HIV patients with CD4 counts <100 cells/mm³, especially in those not receiving prophylaxis.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
Advanced HIV, exposure to Toxoplasma (e.g., undercooked meat, cat feces), and lack of prophylactic treatment.

Prognosis: The expected outcome or course of the condition over time.
Good if treated early; untreated cases have high mortality. Residual neurological deficits may occur.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Persistent neurological deficits, seizures, or progression to coma in severe cases.

Common Drug Interactions with Protease Inhibitors

Specialty: Infectious Diseases

Category: Central Nervous System Complications in HIV

Symptoms:
unexpected drug toxicity; reduced efficacy of protease inhibitors; increased or decreased levels of co-administered medications

Root Cause:
Protease inhibitors interact with liver enzymes, particularly CYP450 enzymes, leading to altered drug metabolism.

How it's Diagnosed: videos
Clinical assessment of symptoms, medication review, and laboratory monitoring of drug levels.

Treatment:
Adjusting dosages, substituting conflicting medications, or switching to alternative regimens with fewer interactions.

Medications:
Adjustments may include avoiding medications metabolized by CYP3A4, prescribing ritonavir (used as a boosting agent), or using therapeutic drug monitoring (TDM).

Prevalence: How common the health condition is within a specific population.
Common in HIV patients on protease inhibitor-based ART regimens; prevalence depends on specific regimens and co-administered drugs.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
Polypharmacy, liver dysfunction, or use of over-the-counter drugs and supplements metabolized by the same enzymes.

Prognosis: The expected outcome or course of the condition over time.
Generally manageable with appropriate monitoring and medication adjustments.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Suboptimal viral suppression, drug toxicity, or organ damage due to interactions.

Cytomegalovirus Encephalitis in HIV

Specialty: Infectious Diseases

Category: Central Nervous System Complications in HIV

Symptoms:
headache; fever; cognitive impairment; seizures; vision changes

Root Cause:
Reactivation of latent cytomegalovirus (CMV) in the setting of severe immunosuppression.

How it's Diagnosed: videos
MRI or CT imaging, CSF analysis via lumbar puncture, and CMV PCR testing.

Treatment:
Antiviral therapy with ganciclovir or valganciclovir; immune restoration through ART.

Medications:
Ganciclovir and valganciclovir are antivirals that target CMV DNA polymerase. Foscarnet may be used in resistant cases.

Prevalence: How common the health condition is within a specific population.
Occurs in 5–10% of untreated HIV/AIDS patients.

Risk Factors: Factors or behaviors that increase the likelihood of developing the condition.
CD4 count less than 50 cells/micro L, untreated HIV, prior CMV infection.

Prognosis: The expected outcome or course of the condition over time.
Poor if untreated; significant improvement with early diagnosis and therapy.

Complications: Additional problems or conditions that may arise as a result of the original condition.
Permanent cognitive deficits, vision loss, or death.