[Guillain-Barré syndrome in HIV-infected patients at Bobo-Dioulasso Hospital (Burkina Faso)].
Neurological manifestations of human immunodeficiency virus (HIV) infection are frequent and several associated peripheral neuropathies have been recognized. Among them, Guillain-Barré syndrome (GBS) may occur either early or during the course of the illness. We present a prospective study of 32 consecutive cases of GBS managed over a 5-Year period at Bobo-Dioulasso Hospital where HIV prevalence reaches 20.1p.cent. Male gender predominated (24/32). GBS occurred during the dry season for 65.7p.cent of the patients. Prior infections were found in 84.4p.cent. The motor deficit was paraplegia or tetraplegia. Clinically, paraplegia was associated with transient urinary sphincteric involvement in 24 HIV-infected patients and 3 HIV negative patients. Facial nerve paralysis was found in 3 patients. Among the 32 patients with GBS, 27 were tested positive for HIV. Two patients were infected by HIV1 and HIV2. Cerebrospinal fluid examination showed albumin-cell dissociation and elevated albumin level in 75p.cent of the samples. Autonomic neuropathies were seen in 9 HIV-infected patients. The CD4 counts were above 200/mm3 in 10 among 18 HIV-infected patients. The clinical presentations were more severe in HIV-positive patients with a longer duration of symptoms. HIV-infected patients walked unaided within 51.1 days of peak paralysis. No fatal event occurred. This study indicates clearly that GBS in young adults is strongly associated with HIV infection and should be considered as an indicator of HIV infection in Black Africans. In the tropical context GBS should lead to HIV screening.
Service de Médecine Interne, Centre Hospitalier National Souro Sanou, Bobo-Dioulasso, Burkina Faso. athanase_millogo@hotmail.com
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Millogo
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Sawadogo
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Lankoandé
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Sawadogo
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000209:etiology; D002050:Burkina Faso / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D020275:Guillain-Barre Syndrome / Q000453:epidemiology / Q000209:etiology*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1; D015498:HIV-2; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D011446:Prospective Studies; D011782:Quadriplegia / Q000209:etiology; D012621:Seasons; D012737:Sex Factors; D014549:Urinary Incontinence / Q000209:etiology