Current clinical presentations of AIDS dementia in a tropical environment: study of twenty-six (26) observations in the Neurology department of the University Hospital of Conakry.

Abstract

Abstract Introduction-In sub-Saharan Africa (SSA), the clinical and progressive diagnostic certainty of AIDS dementia is difficult to establish due to under-medicalization and delays in consultation and especially the diversity of etiologies of demented states. Material and methods: We carried out a retrospective study of 196 patients hospitalized for dementia syndrome between 2016 and 2021 in the neurology department of the University Hospital of Conakry. The criteria labeled in this study are those retained by the DSM-IV and the classification of the American Academy of Neurology (AAN) developed in accordance with the WHO. Results- The HIV etiology was retained in patients aged 44 to 67 (17 women and 19 men). The clinical picture is dominated by severe cognitive disorders, slowing of ideation, memory disorders, reduced motor skills associated with personality change. Neurological examination revealed dysphoric disorders in most patients, sphincter abnormalities in 13 cases and tremor of the labio-lingual region in 11 cases. The diagnosis was based on the positivity of the serological reactions with detection of HIV1 and 2 antibodies by the Elisa and Western Blot technique and the presence of CSF with a discreet hypercellularity. Magnetic resonance imaging contributed to the diagnosis by showing diffuse abnormalities of the white matter in the form of hypersignals on T2- or Flair-weighted sequences. Conclusion-This study shows a non-stereotype clinical picture of AIDS dementia requiring a differential diagnosis with other infectious dementias. These results are important for the therapeutic and prognostic discussion.