Abstract
Neurological syndromes occur in around 40–70% of HIV-infected people. Direct central nervous system involvement by the virus usually manifests as HIV encephalitis, HIV leucoencephalopathy, vacuolar leucoencephalopathy or vacuolar myelopathy. Indirect involvement is usually associated with neurotropic opportunistic infections which include tuberculosis, toxoplasmosis, cryptococcosis and viral encephalitis such as herpes simplex, varicella-zoster, cytomegalovirus and Human polyomavirus 2. We report a case of transverse myelitis in a recently diagnosed HIV patient who was otherwise asymptomatic initially and developed paraparesis after 1 month of initiation of antiretroviral therapy. After ruling out opportunistic infections and other causes of compressive and non-compressive myelopathy, development of transverse myelitis was attributed to immune reconstitution inflammatory syndrome in view of baseline low CD4 count and their improvement after HAART initiation. Prompt treatment with corticosteroids successfully reversed the symptoms.
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All the authors have provided substantial contributions in the clinical management of the case and literature review on the topic in question. Dr. Preeti Dalal and Dr. Karuna Anot have drafted the manuscript, and Dr. Monica Gupta and Dr. Sanjay D’Cruz have revised it critically for important intellectual content. All the authors have read the final version and approved it. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Dalal, P., Anot, K., Monica, G. et al. Acute paraparesis in HIV-infected patient after initiation of highly active antiretroviral therapy. J. Neurovirol. 26, 793–796 (2020). https://doi.org/10.1007/s13365-020-00879-4
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DOI: https://doi.org/10.1007/s13365-020-00879-4