Source
Clinical Trials Centre, Winston Churchill Wing, St Mary's Hospital, London, W2 1NY, UK. l.garvey@imperial.ac.uk
Abstract
BACKGROUND AND PURPOSE:
Data describing the incidence and survival of HIV-related central nervous system diseases (CNS-D) in recent years are sparse.
METHODS:
Between 1996 and 2007, adult subjects without previous CNS-D within a large UK cohort were included (n=30,954). CNS-D were HIV encephalopathy (HIVe), progressive multifocal leucoencephalopathy (PML), cerebral toxoplasmosis (TOXO) and cryptococcal meningitis (CRYP). Associations between demographic, clinical and laboratory parameters with incidence and survival of CNS-D were evaluated using Poisson regression analysis and Kaplan-Meier techniques.
RESULTS:
Six hundred and thirteen new CNS-D occurred in 574 subjects (HIVe:187, PML:113, TOXO:184, CRYP:129). Incidence of all CNS-D declined from 13.1 per 1000 PY in 1996/1997 to 1.0 per 1000 PY in 2006/2007 (P=0.0001). Current CD4+ cell count below 200 cells/ul and plasma HIV RNA above 100,000 copies/ml were independently associated with the development of CNS-D. Calendar year 1996/1997, older age, prior AIDS diagnosis and PML diagnosis were significantly associated with shorter survival.
CONCLUSIONS:
An ongoing decline in the incidence of CNS-D has been observed in very recent years. Mortality following such a diagnosis remains high.
© 2010 The Author(s). European Journal of Neurology © 2010 EFNS.