title: HIV-encephalopathy as initial manifestation of acquired immunodeficiency syndrome in Yucatán State, Mexico.
abstract: BACKGROUND
  The frequency of neurologic manifestations of the central nervous system (CNS) as a defining disease of acquired immunodeficiency syndrome (AIDS) (neurologic manifestation defining disease [NMDD-AIDS]) varies according to geographic region. The aim of this study was to determine its prevalence among patients with AIDS diagnosed in the state of Yucatán, Mexico.
  
  
  METHODS
  We carried out a retrospective study in which AIDS cases reported at the Health Department in the state of Yucatán, Mexico from January 1983 to July 2001 were analyzed. Frequency of NMDD-AIDS and other pathologies were obtained. Frequency of other pathologies between patients with NMDD-AIDS and those without NMDD-AIDS was compared using chi2 and/or Fisher exact test.
  
  
  RESULTS
  A total of 1,175 subjects (1,054 [90%] men and 121 [10%] women) were included in the study. In 186 (16%), NMDD-AIDS were observed. The most common NMDD-AIDS was HIV-encephalopathy in 101 (54%) patients, CNS toxoplasmosis in 65 (35%), meningeal cryptococosis in 16 (8.6%), primary lymphoma of the brain in two (1%), and one (0.5%) case of progressive multifocal leukoencephalopathy. CD4 lymphocytes were statistically different between patients with NMDD-AIDS (n=47) and without (n=312) (mean: 65/microL (33-500) vs. 189/microL (2-989), p<0.005). Higher frequency of oropharyngeal candidiasis, pulmonary tuberculosis, herpetic stomatitis, and mortality was observed in patients with initial neurologic disease.
  
  
  CONCLUSIONS
  Frequency of NMDD-AIDS was similar to some reports from the U.S. but lower than others from Mexico. HIV-encephalopathy was the most frequent manifestation. NMDD-AIDS were associated with advanced stage of immunodeficiency and influenced morbidity and mortality associated with AIDS.
authors.affiliation: Laboratorio de Hematología, Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán (UADY), Mérida, Yucatán, Mexico. castros@tunku.uady.mx
authors.forename: Carlos José
authors.initials: CJ
authors.lastname: Castro-Sansores
authors.forename: Renán A
authors.initials: RA
authors.lastname: Góngora-Biachi
authors.forename: Pedro
authors.initials: P
authors.lastname: González-Martínez
mesh_terms: D015526:AIDS Dementia Complex / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D012189:Retrospective Studies