Abstract

Introduction: Any HIV infected individual with a CD4+ T cell count of less than 200/L has AIDS by definition, regardless of presence of symptoms of opportunistic disease. Neurological complications increase with decline in CD4+ T cell count. With CD4 T cell count less than 500/micro-L- Early stage -Demyelinating Neuropathy CD4 T cell count 200 to 500 – Mid stage- dementia VZV Radiculitis and CD4 T cell count less than 200 -Advance stage -Dementia, myelopathy, painful neuropathy. Plasma viral load independently provide an important prognostic information with regard to AIDS. If CD4 count goes below 250/microliter common neurological manifestations are TB meningitis (TBM), cryptococcal meningitis (CCM), progressive multifocal leukoencephalopathy (PMLE), AIDS dementia complexes (ADC), Acute inflammatory demyelination polyneuropathy (AIDP)^. HIV RNA (viral load) and CD4 T lymphocyte (CD4) cell count are the two surrogate markers of antiretroviral treatment (ART). Response and HIV disease progression that have been used for decades to manage and monitor HIV infection.
Aims & objectives: - 1. To study the neurological manifestations in patients diagnosed with HIV.2. To study CD 4 counts in HIV Patients.3.To study viral load in patients of HIV.4.To study the correlation between neurological manifestations, CD 4 counts and viral load in HIV patients.
Materials & methods: This is a cross sectional study conducted over 86 patients of essential hypertension admitted in department of general medicine, R D Gardi medical college and C R Gardi Hospital, Ujjain (M.P)   during the period from Jan 18 to June 19 after applying the inclusion and exclusion criteria.
Observation and results: In this study most common diagnosis was TBM 25 (56.8 %) patients having CD4 count ≤100 were having TBM,7(100%) patients having CD4 count ≤100 were having toxoplasmosis, 4 (66.7%) patients having CD4 count ≤100 were having BM and 19 (43.2%) patients having CD4 count >100 were having TBM,17(100%) patients having CD4 count >100 were having peripheral neuropathy, 3 (75 %) patients having CD4 count ≤100 were having CVA.
Discussion: All patient with meningitis presented with headache vomiting and fever, focal neurological sign where absent none of these patients had convulsion, Diagnosis of meningitis done on basis of clinical symptoms, Fundoscopic examination was normal specific diagnosis was made on basis of CSF finding all patient had CSF examination had Indian ink preparation done. CSF finding reported in table. We had 44 cases of TBM the incidence of TBM has also found in other studies done by Mehta, et al. these is probably due to strong association of HIV and TB in India,
Conclusion: Neurological manifestations are seen with low CD4 count and high viral load in our study and there is a significant correlation between them hence can be stated that, these are the manifestations of the late stage of the disease, when the level of immunodeficiency has achieved a higher degree and which cloud result in high mortality.