Neurological complications of HIV infection in critically ill patients: Clinical features and outcomes

Summary Objective We aimed to investigate the prognosis of HIV-infected patients with acute neurological complications at the highly active antiretroviral therapy (HAART) era. Methods We performed a retrospective study in HIV-infected patients admitted to a medical ICU with neurological complications between 2001 and 2008. Results Among the 210 studied patients (median [interquartile range] CD4-cell count: 80 [18–254]/μL; HIV viral load: 4.8 [2–5.3] log 10 /mL), 40 (19%) had unknown HIV status at admission. Neurological complications consisted in delirium (45%), coma (39%), seizures (32%) and/or intracranial hypertension (21%). Admission diagnoses were AIDS-defining CNS disease for 88 (42%) patients, non-AIDS-defining CNS disease for 45 (21%), and systemic disease with neurological signs for 77 (37%). Seizures ( p =0.003), focal deficit ( p p Conclusions Prognosis of HIV-infected patients with neurological complications depends rather on clinical presentation than on HIV-related parameters. Intracranial hypertension symptoms at admission have a major impact on outcome.