PMID: 11339484May 8, 2001Paper

Myelopathy in a previously asymptomatic HIV-1-infected patient

Infection
Walter A Eyer-SilvaC A Morais-de-Sá

Abstract

A wide variety of disorders of diverse pathogenic mechanisms can trigger spinal cord dysfunction in HIV-1-infected patients. The most common such condition is HIV-1-associated myelopathy (HM) which characteristically complicates advanced HIV-1 disease in patients with low CD4 cell counts and previous AIDS-defining diagnoses. We describe an unusual presentation of HM in a previously asymptomatic patient with a relatively preserved CD4 cell count (458 cells/mm3) who was even unaware of his serological status. The patient presented with a clinically severe, slowly progressive myelopathy and could not walk unassisted. Significant neurological improvement could be obtained as rapidly as within 4 weeks after the institution of an antiretroviral combination of only two nucleoside analog HIV-1 reverse transcriptase inhibitors (zidovudine and didanosine). An HIV-1 protease inhibitor was also prescribed at that point but could only be added to intensify the regimen 3 months later, when significant neurological improvement had already been recorded. We also review the disorders reported to derange spinal cord function in previously asymptomatic HIV-1-infected patients.

Citations

Aug 10, 2005·Canadian Journal of Microbiology·Jiang TaoLu Feng
Jul 20, 2012·Continuum : Lifelong Learning in Neurology·Joseph R Berger
Aug 12, 2005·Internal Medicine·Yoshio ShimojimaShu-ichi Ikeda
Jul 29, 2008·Neurologic Clinics·Lysa BoisséChristopher Power
Nov 9, 2005·The Journal of Infection·Kerstin AnnekenIngo-W Husstedt

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