African Americans are disproportionately affected by human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS) at a rate that is 10 times greater than the U.S. white population. Three percent of the District of Columbia

1
Neurological Manifestations in HIV-Positive
African American Population
Sherita Chapman, Misan Pessu, Elizabeth Chimah,
Raza L. Khan, Mohankumar Kurukumbi, Annapurni
Jayam-Trouth Department of Neurology, Howard
University Hospital, Washington, DC
Introduction
Results
African Americans are disproportionately affected
by human immunodeficiency virus (HIV) and
acquired immunodeficiency disease syndrome (AIDS)
at a rate that is 10 times greater than the U.S.
white population. Three percent of the District
of Columbia (DC) population has HIV infection,
which is the highest in the nation. Approximately
two-thirds of patients with HIV infection will
develop CNS involvement during the course of
their disease. Several North American and
European studies have reported improved outcomes
of major neurological disorders in HIV-infected
patients receiving combination antiretroviral
therapy, while other studies showed no change in
prevalence. Currently, no literature is
available regarding the demographics and
neurological manifestations in the African
American population with HIV infection.
Demographic Characteristics
Relationship of CD4 count and Neuropsychiatric
Manifestations
Characteristics Number Percentage Mean
Gender Male Female 152 130 54 46
Mean Age (years) 47 (16-83)
HIV Diagnosis Pre-admission At Hospital 279 3 99 1
Antiretroviral therapy (n 276) Yes No 170 106 62 39
Drug Abuse History (n 276) Yes No 236 39 86 14


Conclusion
Demographic Relationship of Neuro-manifestations
This study shows that neuropsychiatric disease is
the most common neurologic manifestation of HIV
infection within the African American population
studied with depression as the most common
subtype. A relatively higher percentage of
patients with neuropsychiatric presentations had
CD4 counts gt 200. This could indicate that
there is a paradigm shift of neurological
diseases from opportunistic infections to
neuropsychiatric manifestations, and this may be
related to longer survival secondary to effective
antiretroviral treatment. In addition, a
significant percentage of patients reported of a
history of drug use. In respect to drug use,
there was no significant difference among the
percentage of patients with CD4 counts lt200 vs. gt
200. This could indicate that immune status of
HIV patients does not play a role in their
behavior (drug abuse). However, a prospective
study is needed to confirm these conclusions.
Aim
To study the prevalence and neurological
manifestations associated with HIV in African
Americans in the DC metropolitan area.

Design/Method
Medical records of 282 consecutive HIV-positive
African American patients with concurrent
neurological diagnosis admitted in 2010 to Howard
University Hospital, Washington, DC were
retrospectively reviewed for demographic
variables, neurological manifestations in
relation to CD4 counts.
Relationship of Drug Use on Neuro-manifestations
Disclosure Statement

References
Dr. Chapman has nothing to disclose. Dr. Khan has
nothing to disclose. M. Pessu and E. Chimah has
nothing to disclose. Dr. Kurukumbi has nothing
to disclose. Dr. Trouth has nothing to disclose.
UNAIDS, WHO (December 2007). 2007 AIDS Epidemic
update. Worldwide AIDS HIV Statistics.
AVERT. 31 December 2009. Hogg RS, Heath KV, Yip
B, et al. Improved survivial among HIV-infected
individuals following initiation of
antiretroviral therapy. JAMA 1998 279450-4.