Establishment of a multi-disciplinary platform for HIV-infected patients with neurological complications.

Détails

ID Serval
serval:BIB_FDBC807BDBB6
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Poster: résume de manière illustrée et sur une page unique les résultats d'un projet de recherche. Les résumés de poster doivent être entrés sous "Abstract" et non "Poster".
Collection
Publications
Titre
Establishment of a multi-disciplinary platform for HIV-infected patients with neurological complications.
Titre de la conférence
Scientific Abstract Listing of the 66th Annual Meeting,
Auteur(s)
du Pasquier R., Simioni S., Alves D., Meuli R., Maccaferri G.E., Berney A., Cavassini M.
Editeur
American Academy of Neurology (AAN)
Adresse
Philadelphia, PA, 26/4-3/05/2014.
Statut éditorial
Publié
Date de publication
08/04/2015
Peer-reviewed
Oui
Volume
82
Numéro
10
Série
Neurology
Pages
88
Langue
anglais
Résumé
OBJECTIVE: To describe the functioning and clinical results of the first multi-disciplinary neuro-HIV platform for HIV-infected patients in Switzerland. BACKGROUND: Despite the availability of combination antiretroviral therapy (cART), neurological complications, in particular the cognitive ones, remain a challenge in HIV-infected patients. Frequently, co-morbidities are intermingled with HIV, rendering the diagnostic and therapeutic procedures difficult in these patients. DESIGN/METHODS: In March 2011, we set up, at the Lausanne University Hospital, a multi-disciplinary Neuro-HIV Platform composed of infectiologists, neurologists, neuropsychologists, psychiatrists, and neuroradiologists. During a day-hospitalization, the patient benefits from a clinical evaluation by all these specialists, together with blood work-up, brain MRI and lumbar puncture. At the end of the day, diagnosis and treatment plan are discussed by the whole team. RESULTS: From March 2011 to September 2013, we evaluated 75 consecutive patients (49 men, 49.8±9.3 y, nadir CD4+ T cells 170.8±143.8 cells/mm3, current CD4+ 569.9±258 cells/mm3, 75% with undetectable plasma HIV RNA, 90% with undetectable CSF viral load, 99% on cART, revised CPE score 7.6±1.6). Main referral cause was cognitive complaints (89%), which were confirmed in 78% of those. The leading causes of cognitive disorders were psychiatric conditions (44% of all the confirmed) and HIV-associated neurocognitive disorders (HAND) (29%). Neurological deficits were evidenced in 47% of the total cohort (central signs in 20%; peripheral signs in 27%). Brain MRI was abnormal in 52%, mostly due to slight to moderate cortical/subcortical atrophy. The presence of HAND was correlated with a lower nadir CD4+ T cells (p=0.007). No other correlation was found between HIV disease status and neurological deficits. CONCLUSIONS: Neurological/neuropsychological complications are frequent in well-treated HIV+ patients, consisting mainly in cognitive disorders. The latter are more often ascribed to a psychiatric condition than to HIV infection itself. A multi-disciplinary approach is a real asset to take care of these complex patients.
Création de la notice
04/01/2017 13:39
Dernière modification de la notice
20/08/2019 16:28
Données d'usage