Neurological Manifestations in HIV-Positive African American Population (P01.258)

Objective: To study the prevalence and neurological manifestations associated with human immunodeficiency virus infection in African Americans in the District of Columbia (DC) metropolitan area. Background Approximately two-thirds of patients with HIV infection will develop CNS involvement during the course of their disease. Three percent of the DC population has HIV infection, which is the highest in the nation. Currently, no literature is available regarding the demographics and neurological manifestations in the African American population with HIV infection. Design/Methods: Medical records of 282 consecutive HIV-positive African American patients with concurrent neurological diagnosis admitted in 2010 to Howard University Hospital, Washington, DC were retrospectively reviewed for demographic variables, neurological manifestations and in relation to CD4 counts. Results: Of the 282 hospitalized patients, 152 were males and 130 were females, with a median age of 47. There were 121 patients CD4 counts > 200, and the most common concurrent neurological diagnosis was neuropsychiatric in nature, which was seen in all patients. These manifestations included depression, bipolar disorder, schizophrenia and psychosis. The other non neuropsychiatric manifestations included epilepsy in 23 patients, ischemic stroke in 19 patients, peripheral neuropathy in 14 patients and opportunistic infections in 4 patients. Eighty-nine patients were presented with CD4 counts Conclusions: The study concluded that neuropsychiatric disease is the most common neurologic manifestation among the African American population with HIV infection, with a relatively higher number among those with CD4 >200. There is a paradigm shift of neurological diseases from opportunistic infections to neuropsychiatric manifestations, which may be related to longer survival secondary advent of effective antiretroviral treatment. Disclosure: Dr. Chapman has nothing to disclose. Dr. Pessu has nothing to disclose. Dr. Chimah has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Kurukumbi has nothing to disclose. Dr. Jayam-Trouth has nothing to disclose.