Neila Raisa (Indonesia)
Neurology Departement Faculty of Medicine Brawijaya/ General Hospital of dr. Saiful AnwarAuthor Of 1 Presentation
SERIAL CASE OF HIV ASSOCIATED NEUROCOGNITIVE DISORDER
- Nurvia Andriani (Indonesia)
Abstract
Background and Aims:
HIV Associated Neurocognitive Disorder (HAND) divides into three severity categories, which include asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HIV-associated dementia (HAD). This case report aims to present and compare the serial case of two patients' clinical manifestations that are diagnosed and treated for HAND.
Methods:
This is a prospective serial case of two patients. A 23-year-old male came with complaints of frequent senility and mild headache. He is diagnosed with HIV infection with CD4 9 Cell/µL and cerebral toxoplasmosis. Head MRI results show a solitary lesion in the right lentiform nucleus and right external capsule exemplify cerebral toxoplasmosis. Neuropsychological test results, there are dysfunctions of attention, language, and visuospatial domains without daily activity dysfunction with International HIV Dementia Scale (IHDS) 10. The second patient was a 33-year-old male who came with complaints of frequent senility and oculomotor nerve dysfunction. He is diagnosed with HIV infection with CD4 103 Cell/µL, and cerebral toxoplasmosis. Head MRI results show multiple bilateral frontotemporooccipital intraaxial lesions with suspected cerebral toxoplasmosis. Neuropsychological test results, there are dysfunctions of attention, language, and executive domains without daily activity dysfunction with IHDS 10.
Results:
In both cases, patients diagnosed with HAND with asymptomatic neurocognitive impairment.
Conclusions:
HAND is a rare manifestation of HIV infection. In this case, HAND with ANI due to HIV infection is suspected by patients' risk factors and major HIV-associated CNS disorders. Neuropsychological tests, primarily IHDS may help make a differential diagnosis.