Neurological complications in patients with Human Immunodeficiency Virus infection at the Japanese Hospital in Santa Cruz, Bolivia

Introduction: Neurological involvement is common among patients with Human Immunodeficiency Virus (HIV) infection. Between 40 and 60% will develop symptomatic neurological complications with high morbidity and mortality at some point. Objective: To analyze the clinical-epidemiological characteristics of patients with HIV infection who develop neurological complications at the Japanese Hospital of Santa Cruz de la Sierra in the period between March 2019 and February 2022. Methods: Observational, descriptive, prospective, cross-sectional study. Universe and Sample: Patients admitted through the Emergency Service of the Japanese Hospital with a confirmed diagnosis of Human Immunodeficiency Virus Disease during the period between March 2019 and February 2022 Results and discussion: A total of 42 patients were evaluated, the majority of whom were men and had a younger average age. For both sexes, the majority of patients reported having a source of employment. Regarding sexual orientation, almost all women reported being heterosexual, while men were more variable, with the majority being bisexual. Three clinical syndromes were identified at admission. The frequency of focal syndrome was dominant in women, but was not significantly different from the others. In men, meningeal syndrome and focal syndrome were the dominant ones, significantly exceeding non-focal syndrome. Ten neurological complications were identified, cerebral toxoplasmosis was the most frequent, followed by cerebral cryptococcosis and meningeal tuberculosis. Considering all patients in general, their typical hospital stay was 11 days with a range between 2 and 56 days. Of the 42 patients evaluated, it was only possible to measure the CD4 status for 27. Conclusions: The young male population with employment in the city of Santa Cruz with aberrant sexual behavior was the most affected. Focal syndrome was the most frequent form of presentation, in the form of cerebral toxoplasmosis. Severely low levels of immunosuppression were found in the study population. Hospital stay is variable and is longer in cases of focal syndrome and meningeal syndrome. We consider it important to continue the present study, which will allow us to increase the sample size.