Relationship of neurological manifestations, CD4+ lymphocyte count and plasma viral load in HIV infected patients.

The aim of the study was to assess the relationship between the neurological manifestations of HIV infection, CD4+ lymphocyte count and the levels of HIV-1 RNA (viral load) in plasma. A total of 62 adult antiretroviral naïve HIV infected patients were enrolled in the study. Among them 26 had neurological complications of HIV infection (1st group), 16 patients had symptomatic disease without neurological involvements (2nd group) and 20 were asymptomatic patients (control group). Measurement of CD4 count was performed by indirect immunofluorescent assay by using the monoclonal antibodies and viral load (VL) in plasma--by RT PCR method. CD4 count was significantly lower in the 1st and 2nd group compared to the control group. There was correlation between the level of CD4 count and type of neurological manifestation. VL was comparable between the 1st and 2nd groups and was higher than in control group. There is a significant correlation between the level of CD4 count and type of neurological manifestation of HIV infection. Presence of neurological complication as well as other clinical manifestations is associated with decreased CD4 count and increased VL. Level of CD4 count can serve as an indicator for initiation of prophylaxis treatment of certain opportunistic pathogens.