A Patient with HIV Encephalopathy Presenting with Parkinsonism during HAART Therapy

Accession number;06A0542392
Title;A Patient with HIV Encephalopathy Presenting with Parkinsonism during HAART Therapy
Author; SHIMOHATA TAKAYOSHI (Niigata Univ., JPN) TAKADO YUHEI (Niigata Univ., JPN) TERAJIMA KENSHI (Niigata Univ., JPN) TERAJIMA KENSHI (Niigata Univ., JPN) TSUKADA HIROKI (Niigata Univ., JPN) GEJO FUMITAKE (Niigata Univ., JPN) TANAKA KEIKO (Niigata Univ., JPN) NISHIZAWA MASATOYO (Niigata Univ., JPN)
Journal Title;Brain Nerve
Journal Code:Z0685A
ISSN:0006-8969
VOL.58;NO.6;PAGE.495-499(2006)
Figure&Table&Reference;FIG.4, REF.10
Pub. Country;Japan
Language;Japanese
Abstract;We report the case of a 32-year-old man presenting symptoms of parkinsonism. Neurological examination revealed parkinsonism symptoms such as akinesia and postural instability, dementia and frontal lobe signs. He was diagnosed as having human immunodeficiency virus (HIV) encephalopathy. Brain MRI, '99m'Tc ECD-SPECT and '1'H-MR spectroscopy demonstrated symmetrical cerebral white matter lesions, predominantly in the bilateral frontal lobes. Frontal lobe dysfunction could be responsible for his parkinsonism associated with HIV encephalopathy. His neurological symptoms improved transiently after the initiation of HAART but fluctuated when antiretroviral drugs were changed because of their side effects. Although HAART effectively decreased plasma HIV-RNA load and increased peripheral blood CD4 cell count, his parkinsonism and dementia eventually exacerbated. Our results suggest that a combination of antiretroviral drugs affects the therapeutic efficacy against HIV encephalopathy, and that CNS symptoms could be aggravated during HAART, even when plasma HIV-RNA load and CD4 cell count are maintained under favorable conditions. (author abst.)
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