HIV-related neurological complications in Cameroon in the era of Test and Treat strategy: prevalence and mortality

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These conditions could be associated with poor outcome. This study aimed to determine the prevalence of HIV-related neurological complications and to identify factors associated with mortality among these patients. Materials and method: This was a retrospective cohort study from January 1 st , 2016, to 31 December 31 st , 2023, in Laquintinie and General hospitals in Douala. We reviewed all patient with HIV records, and we included those with HIV-related neurological complication. Demographic, clinical, laboratory, neuroimaging, and therapeutic data were collected. Univariate and multivariate logistic regression analysis were performed to identify predictive factors of mortality. Results: Among 15,521 admission, 1,058 (6.8%) were PLHIV, including 435 (41.1%) with HIV-related neurological complications. The mean age was 45.5±11.7 years, and 58.4% were women. CD4 count and viral load were unavailable in more than 85% of cases. Cerebral toxoplasmosis (33.3%), meningoencephalitis of undetermined etiology (25.3%), and cryptococcal meningitis (9.2%) were the most common etiologies. The overall mortality rate was 29.4%. In multivariate analysis, cerebral toxoplasmosis (aOR:4.57, 95%CI:1.59 – 13.17, p=0.005), and meningoencephalitis of unknown etiology (aOR: 1.78, 95%CI:1.03–3.06, p=0.038) were independent predictors of death. Conclusion: HIV-related neurological complications remain common and deadly in our setting, with cerebral toxoplasmosis and meningoencephalitis of unknown etiology emerge as major contributors to mortality. Limited access to immunovirological and advanced diagnostic testing likely contribute to delayed diagnosis and poor outcomes. Prospective studies are needed to refine diagnostic algorithm and improve survival in affected patients. HIV-related neurological complications CD4 count viral load meningoencephalitis of unknown etiology cerebral toxoplasmosis mortality Figures Figure 1 Introduction Human immunodeficiency virus (HIV) infection remains a global public health problem ( 1 ). About 1.3 million new HIV infections were recorded in 2023 ( 2 ). HIV leads to immunosuppression which favors the occurrence of opportunistic diseases. These opportunistic diseases can affect the nervous system and cause damages of varying severity. HIV-related neurological complications can occur at any stage of the disease and cause significant morbidity and mortality ( 3 – 5 ). The spectrum of HIV-related neurological complications is broad concerning any part of the nervous system, and they represent 10% of circumstances of HIV diagnosis ( 1 , 2 ). Highly active antiretroviral treatments (HAART) have contributed reduce the spread of infection, but the frequency of HIV-related neurological complications remains high. Delayed diagnosis of HIV-related neurological complications have an impact on patient outcome ( 6 , 7 ). In Cameroon, HIV-related neurological complications represent the most common cause of CNS infections ( 8 , 9 ). In 1986, the initial response of the Cameroon government to the increasing trends in the HIV/AIDS infection was to create a National AIDS Control Committee to coordinate a national AIDS program ( 10 ). Since that period, several strategies have been implemented to reduce the prevalence of HIV and opportunistic infections. In 2018, the State of Cameroon adopted the "Test and Treat" strategy, the aim of which was to treat newly diagnosed HIV-positive patients directly, regardless of their CD4 count ( 11 , 12 ). It seems important to us to evaluate the frequency and outcome of neurological complications of HIV during this era. Material and Methods Study design and setting: We conducted a retrospective cohort study in the internal medicine departments of the Laquintinie hospital of Douala (LHD) and the Douala General Hospital (DGH). We reviewed the data of patients diagnosed of HIV from January 1 st , 2016, to December 31 st , 2023. These two health facilities are the main teaching and referral hospitals in the city of Douala (economic hub of Cameroon). These health facilities comprise HIV treatment centers, neurology units, imaging centers, and central laboratories. In both hospitals, imaging centers include CT scan and MRI, while central laboratories perform basic CSF analysis to identify common bacterial germ, cryptococcus neoformans, soluble antigens. The polymerase chain reaction (PCR) for Mycobacterium tuberculosis in CSF sample is freely available at the Regional Delegation for Public Health located in the administrative center of the city. Data collection: We collected data of patients followed up for HIV-related neurological complications. Incomplete medical records were excluded. We documented: Demographic characteristics: age, sex, occupation, marital status, residence, education level. Clinical features: history of chronic infections (e.g. tuberculosis) or comorbidities (e.g. hypertension, diabetes mellitus), general signs, Glasgow coma scale (GCS), neurological and systemic examination, WHO clinical stage of HIV. Paraclinical investigations: CD4 count (per mm 3 ), viral load (detectable and undetectable), CSF analysis, neuroimaging (brain CT scan/MRI) findings. Etiologies of HIV-related neurological complications: cerebral toxoplasmosis, cryptococcal meningitis, tuberculous meningitis, HIV encephalitis, stroke, progressive multifocal leukoencephalopathy, myelitis, … Treatment details: HAART regimen, delay in HAART initiation, change in HAART regimen, opportunistic infection prophylaxis. Outcome: hospitalization and mortality. Statistical analysis The data were collected and analyzed using Epi info software version 7.2.1.0. In the descriptive statistics, continuous variables were expressed as mean (standard deviation), and categorical variables were presented as frequency (percentage). Chi-square test was used to compare categorical variables. We performed a univariate and multivariate logistic regression models to identify associated and predictive factors of in-hospital mortality in patients with HIV-related neurological complications. The significance threshold was set at p < 0.05. Ethical considerations: Ethical approval was obtained from the Institutional Ethics Committee of the University of Douala (N°4140/CEI-UDo/04/2024/T). This research was conducted in accordance with the ethical standards of the Institutional Ethics Committee of the University of Douala and the Declaration of Helsinki. Results Among 15,521 admissions in internal medicine departments of these hospitals, 1,058 (6.8%) were people living with HIV (PLHIV) including 435 (41.1%) admission for HIV-related neurological complications (Fig. 1 ). The mean age of patients was 45.5 (11.7) years and women accounted for 58.4% of cases. Newly diagnosed PLHIV represented 26.9% of patients. Altered mental status (18.8%), motor weakness (18.1%), and headaches (17.5%) were the main complaints. 64.8% of patients were WHO clinical stage IV. A CD4 count and viral load were not available in 85% and 86.7% respectively (Table 1 ). Table 1 Demographic and clinical characteristics of patients with HIV-related neurological complications. Variables n % Age groups 21–30 35 8.0 31–40 107 24.6 41–50 144 33.1 51–60 104 23.9 > 60 45 10.3 Sex Female 254 58.4 Male 181 41.6 Job Employed 260 59.8 Unemployed 175 40.2 Marital status Single 199 45.7 Married 161 37.0 Unmarried couple 21 4.8 Widow 52 12.0 Divorced 2 0.5 Education level No 165 37.9 Primary 91 20.9 Secondary 104 23.9 University 74 17.0 Comorbidities Hypertension 69 15.9 Previous neurological diseases 59 13.6 Tuberculosis 46 10.6 Diabetes mellitus 8 1.8 Neurological complaints Altered mental status 82 18.9 Motor weakness 79 18.2 Headaches 76 17.5 Seizures 46 10.6 Delirium 22 5.1 Speech disorders 15 3.4 Sleep disorders 6 1.4 Non-neurological complaints Altered general status 72 16.6 Fever 19 4.4 Diarrhea and vomiting 18 4.1 WHO clinical stage Stage I 11 2.5 Stage II 30 6.9 Stage III 112 25.7 Stage IV 282 64.8 CD4 count (per mm3) 500 12 2.8 Undetermined 370 85.1 Viral load Undetectable 30 6.9 Detectable 28 6.4 Undetermined 377 86.7 Virus sub-type Type 1 HIV 226 52.0 Type 2 HIV 0 0.0 HIV 1 + 2 0 0.0 Untyped 209 48.0 The most common etiologies of HIV-related neurological complications were cerebral toxoplasmosis (33.3%), meningoencephalitis of undetermined cause (25.3%), and cryptococcal meningitis (9.2%), see Table 2 . In this study, 64.2% of patients were on first-line ART, particularly TDF/3TC/TDG. ART had not yet been initiated in 26.9% (n = 117) of patients. At least 75% (n = 327) of patients were not on sulfamethoxazole/trimethoprim prophylaxis. Table 2 Etiologies of HIV-related neurological complications. Variables n % Cerebral toxoplasmosis 145 33.3 Meningoencephalitis of undetermined cause 110 25.3 Cryptococcal meningitis 40 9.2 Ischemic stroke 37 8.5 HIV encephalitis 36 8.3 Hemorrhagic stroke 18 4.1 Brain tumor 11 2.5 Tuberculous meningitis 7 1.6 Epilepsy 7 1.6 Progressive Multifocal Leukoencephalopathy 6 1.4 Sub-arachnoid hemorrhage 5 1.1 Compressive myelopathy 5 1.1 Brain abscess 4 0.9 Peripheral neuropathy 3 0.7 Migraine 1 0.2 The in-hospital mortality rate was 29.4%, and the mean length of hospital stay was 39.18 ± 3.2 days (median 6.5; interquartile range 3–12 days). The most common causes of death were meningoencephalitis of undetermined etiology (56.3%), cerebral toxoplasmosis (25.8%) and cryptococcal meningitis (8.6%), Table 3 . Table 3 Frequency of HIV-related neurological complications among deceased patients Variables n % Meningoencephalitis of unknown etiology 72 56.3 Cerebral toxoplasmosis 33 25.8 Cryptococcal meningitis 11 8.6 Tuberculous meningitis 3 2.3 Hemorrhagic stroke 3 2.3 Progressive Multifocal Leukoencephalopathy 2 1.5 Sub-arachnoid hemorrhage 2 1.5 Ischemic stroke 2 1.5 Total number of deceased: 128 Analytical study and search for associated factors In univariate analysis, lack of HAART (OR: 26.58, 95%CI:15.27–46.28, p < 0.001), undetermined viral load (OR: 6.46, 95%CI:1.51–27.55, p = 0.004), cerebral toxoplasmosis (OR: 2.88, 95%CI:1.13–7.37, p = 0.027), and meningoencephalitis of unknown etiology (OR: 9.10, 95%CI:5.59–14.81, p < 0.001) were significantly associated with in-hospital mortality among patients with HIV-related neurological complications (Table 4 ). Multivariate logistic regression identified cerebral toxoplasmosis (aOR:4.57, 95%CI:1.59–13.17, p = 0.005) and meningoencephalitis of unknown etiology (aOR: 1.78, 95%CI:1.03–3.06, p = 0.038) as independent predictors of death in this cohort (Table 4 ). Table 4 Associated and predictive factors of death among patients with HIV-related neurological complications. Variables Deaths n (%) Survivors n (%) OR 95% CI p-value aOR 95%CI p-value Demographics Age ≥ 46 years 63 (46.7) 72 (53.3) 1.34 0.84–2.14 0.217 1.64 0.99–2.72 0.055 Female sex 79 (43.9 101 (56.1) 1.12 0.70–1.81 0.636 1.03 0.62–1.71 0.901 Comorbidities Hypertension 14 (34.1) 27 (65.9) 0.65 0.33–1.31 0.229 0.66 0.32–1.36 0.256 Tuberculosis 16 (48.5) 17 (51.5) 1.30 0.63–2.68 0.485 1.35 0.62–2.92 0.444 STX-TMP prophylaxis Yes 38 (35.2) 70 (64.8) -- -- REF -- -- -- No 90 (27.5) 237 (72.5) 1.43 0.90–2.27 0.130 1.44 0.851–2.428 0.175 HAART Yes 37 (11.6) 281 (88.4) -- -- REF -- -- -- No 91 (77.8) 26 (22.2) 26.58 15.27–46.28 < 0.001 -- -- -- Glasgow coma scale 15 70 (58.8) 49 (47.2) -- -- REF 0.34 0.12–0.97 0.044 9–14 25 (10.4) 215 (89.6) 0.08 0.05–0.14 < 0.001 -- -- -- ≤ 8 33 (43.4) 43 (56.6) 0.54 0.30–0.96 0.036 -- -- -- CD4 count (per mm 3 ) ≥ 200 144 (55.6) 115 (44.4) -- -- REF -- -- -- < 200 24 (72.7) 9 (27.3) 0.47 0.21–1.05 0.065 0.43 0.19–0.97 0.042 Viral load Undetectable 2 (6.7) 28 (93.3) -- -- REF -- -- -- Detectable 7 (25.0) 21 (75.0) 4.67 0.88–24.80 0.054 -- -- -- Undetermined 119 (31.6) 258 (68.4) 6.46 1.51–27.55 0.004 0.53 0.19–1.48 0.223 WHO Stage Stage I 2 (18.2) 9 (81.8) 1.00 -- REF -- -- -- Stage II 3 (5.4) 27 (94.6) 0.50 0.07–3.49 0.478 -- -- -- Stage III 19 (17.0) 93 (83.0) 0.92 0.18–4.60 0.918 -- -- -- Stage IV 104 (36.9) 178 (63.1) 2.63 0.56–12.40 0.205 4.22 0.90–19.80 0.068 Etiologies Cerebral toxoplasmosis 33(22.8) 112 (77.2) 2.88 1.13–7.37 0.027 3.95 1.42–11.03 0.009 Meningoencephalitis (UE) 72 (65.5) 38 (34.5) 9.10 5.59–14.81 < 0.001 1.78 1.03–3.06 0.038 Cryptococcal meningitis 11 (27.5) 29 (72.5) 1.14 0.30–4.35 0.843 1.89 0.41–8.63 0.410 Ischemic stroke 2(5.4) 35(94.6) 0.12 0.03–0.52 < 0.001 -- -- -- HAART: highly active antiretroviral treatment; STX-TMP: sulfamethoxazole-trimethoprim, UE: unknown etiology. Discussion The present study aimed to determine prevalence of HIV-related neurological complications and identify factors associated with in-hospital mortality among patients in two referral hospitals in Douala. We observed that over 40% of PLHIV admitted during the study period presented with neurological complications of HIV (neuro-HIV), with cerebral toxoplasmosis accounting for one-third of cases. More than 85% of patients lack CD4 count or viral load measurements, reflecting limited immunological and virological monitoring. The prevalence of HIV in our hospital cohort aligns with that reported by Gams et al. in 2022, ranging from 2.2% to 2.6% ( 13 ). Similarly, the proportion of neuro-HIV cases mirrors the 44.6% reported by Luma et al. in 2013 ( 9 ). Millogo et al. and Djagadou et al. found respectively a prevalence of neurological disorders in HIV of 14.7% and 15.1% ( 14 , 15 ). This difference could be explained by the fact that the cases in the study were recruited over a short period and on a smaller sample. Furthermore, the study carried out in Burkina Faso by Millogo et al. showed that in 40–75% of cases, neurological manifestations occur during the AIDS phase, and in 10% of cases they are the first signs of infection( 14 ). The latest national HIV prevalence figures from the Demographic Health Survey (EDS 2018) were 2.7% for the 15–49 age group, with over 40% of PLHIV presenting neuro-HIV ( 16 ). The mean age of patients in our cohort is consistent with several African series ( 18 – 19 ), though slightly older than populations reported by Adoukonou et al. ( 2015) and Apetse et al. (2015) ( 17 , 20 ). Female represented the majority of cases, similar to Rolland et al., reflecting the feminization of the HIV epidemic in Sub-Saharan Africa, where women account for 53% to 61% of adults living with HIV ( Joint United Nations Programme on HIV/AIDS (UNAIDS ), 2024) ( 21 ). This is further corroborates by the results of the Demographic and Health Survey (DHS) in Cameroon, showing HIV prevalence of 5.6% in women versus 2.9% in men ( 2 ). Altered mental status, motor weakness, and headaches were the most common presenting complaints, consistent with findings by Rolland et al., and Gams et al., ( 13 , 21 ). Cerebral toxoplasmosis, meningoencephalitis and cryptococcal meningitis were leading etiologies in line with previous reports by Luma et al., (2013) and Gams et al., (2022) ( 9 , 13 ). These data align with reports from several studies of neuro-HIV ( 22 – 25 ). These observations underscore the frequent central nervous system involvement in HIV, likely driven by both immunosuppression induced by the virus, and direct viral neurotoxicity. The high proportion of patients without CD4 count and viral load testing may reflects the Cameroon’s national “Test and Treat” strategy, which recommend to initiate the HAART to newly diagnosed PLVIH, regardless of immunological and virological parameters ( 11 ). Or may also indicates current limitations in immunological and virological assessments. In our cohort, the in-hospital mortality rate of 29.4% is slightly higher to that reported by Gams et al., (23.5%) in people with central nervous system infections with and without HIV ( 13 ). This likely reflects the substantial contribution of HIV to adverse outcomes in central nervous system infections. Higher mortality rates were observed by Traoré et al., and Déguénonvo et al., ( 19 , 26 ). This were likely influenced by limited hospital resources, delayed consultations, and socioeconomic barriers ( 19 ). The implementation of free healthcare HIV programs in Cameroon over the past decades appears to have contributed to reduce mortality, from 49% reported by Luma et al., (2013) to less than 30% in the current cohort ( 9 ). Analytical statistics revealed that cerebral toxoplasmosis and meningoencephalitis of unknown etiology were independent predictors of death. Univariate analysis also highlighted the contribution of the absence of HAART and undetermined viral load to in-hospital mortality. This underscores the importance of early HAART initiation, timely diagnosis, and systematic management of neurological complications of HIV. Comparable observations have been reported by other studies who identified advanced WHO stage, absence of HAART, delayed consultation, and meningoencephalitis of unknown etiology as significant predictive factors of mortality ( 13 , 21 ). Furthermore, Luma et al. found low CD4 cell count strongly associated with death ( 9 ). This shows that challenges in the monitoring of PLHIV can lead to death. Collectively, these data highlight that delay in monitoring and managing PLVIH significantly contribute to mortality from neuro-HIV. Despite the crucial findings, this study has several limitations. Its retrospective design relies on the completeness of medical records, introducing potentials information and selection bias, particularly with the exclusion of incomplete medical files. The high proportion of missing immunological and virological data such as CD4 count and viral load measurement limited our ability to assess immune status and its relationship with outcomes. Diagnostic constraints such as limited access to MRI, and advanced CSF analysis likely contributed to substantial number of cases classified as meningoencephalitis of unknown etiology. In addition, we were unable to evaluate HAART adherence, timing of symptom onset, and variations in clinical management across sites. As the study was conducted in two referral hospital in an urban area, these finding could not be generalized to the entire population of PLHIV in Cameroon. Conclusion HIV-related neurological complications remain a major cause of mortality and morbidity, with cerebral toxoplasmosis and meningoencephalitis of unknown etiology emerging as predictors of in-hospital death. The high burden of severe disease, late clinical presentation, limited availability of immunological and virological assessment, and lack of advanced diagnostic testing underscore the challenges in the management of neuro-HIV. Strengthening early HIV diagnosis, improve routine immunovirological monitoring, ensuring timely access to neuroimaging and CSF diagnostics, reinforcing adherence to HAART, and prophylactic regiment are essential to reduce mortality. Prospective studies with comprehensive diagnostic approach could better identify etiologies and improve outcomes for patients with HIV-related neurological complications in a resource-limited setting. Declarations Acknowledgment We sincerely express our gratitude to the administrative board and medical archives departments of Douala Laquintinie and Douala General Hospital for their assistance in assessing patients records and facilitating data retrieval. Their support was essential to the successful completion of this study. Author’s contribution AMM: conceptualization, data collection, data analysis, manuscript drafting. DGM: study design, methodology, data interpretation, critical manuscript revision. VDPM: data collection, clinical assessment, manuscript drafting. JIID: data analysis and interpretation, critical manuscript revision. VS: data interpretation, critical manuscript revision. CKT: supervision, critical manuscript revision. NYM: supervision, conceptualization, data interpretation, critical manuscript revision. All authors reviewed the manuscript. Funding The authors declare that they received no specific funding for this study. Competing interests The authors declare that they have no competing interests. Availability of data and materials The dataset used during this study are available from the corresponding authors on reasonable request. Ethics approval and consent to participate Ethical approval for this study was obtained from the Institutional Ethics Committee of the University of Douala (N°4140/CEI-UDo/04/2024/T). As this was a retrospective review of medical records, the requirement of informed consent was waived. All data were anonymized to ensure confidentiality. Consent for publication Not applicable. References Galvani AP, Pandey A, Fitzpatrick MC, Medlock J, Gray GE. Defining control of HIV epidemics. Lancet HIV. nov 2018;5(11):e667‑70. HIV.gov [Internet]. [cité 29 oct 2024]. 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Cite Share Download PDF Status: Published Journal Publication published 29 Apr, 2026 Read the published version in BMC Infectious Diseases → Version 1 posted Editorial decision: Revision requested 12 Feb, 2026 Reviews received at journal 06 Feb, 2026 Reviews received at journal 01 Feb, 2026 Reviews received at journal 30 Jan, 2026 Reviewers agreed at journal 28 Jan, 2026 Reviewers agreed at journal 27 Jan, 2026 Reviewers agreed at journal 22 Jan, 2026 Reviewers agreed at journal 20 Jan, 2026 Reviewers agreed at journal 20 Jan, 2026 Reviewers invited by journal 20 Jan, 2026 Editor invited by journal 08 Dec, 2025 Editor assigned by journal 05 Dec, 2025 Submission checks completed at journal 05 Dec, 2025 First submitted to journal 26 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8213367","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":577768813,"identity":"fd906bcc-2fc6-4855-8561-6107f0cdb9b2","order_by":0,"name":"Annick Mélanie Magnerou","email":"","orcid":"","institution":"University of Douala","correspondingAuthor":false,"prefix":"","firstName":"Annick","middleName":"Mélanie","lastName":"Magnerou","suffix":""},{"id":577768815,"identity":"29d3da3a-9c0d-4638-9260-3926ccdd14d6","order_by":1,"name":"Daniel Gams 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08:31:53","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":117508,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8213367/v1/9ff68ee69324de37fbd21c3b.html"},{"id":100866141,"identity":"244fa93a-c008-4ef3-aaed-9775e5478905","added_by":"auto","created_at":"2026-01-22 08:31:54","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":70662,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of patient inclusion in the study.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8213367/v1/6701b340f4467ad40c640c12.png"},{"id":108438824,"identity":"7980c7c4-aa70-4af4-b624-282dd3b73453","added_by":"auto","created_at":"2026-05-04 16:10:44","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":586204,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8213367/v1/f470c70f-aa03-4863-8b0e-d122aad53795.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"HIV-related neurological complications in Cameroon in the era of Test and Treat strategy: prevalence and mortality","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHuman immunodeficiency virus (HIV) infection remains a global public health problem (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). About 1.3\u0026nbsp;million new HIV infections were recorded in 2023 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). HIV leads to immunosuppression which favors the occurrence of opportunistic diseases. These opportunistic diseases can affect the nervous system and cause damages of varying severity. HIV-related neurological complications can occur at any stage of the disease and cause significant morbidity and mortality (\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The spectrum of HIV-related neurological complications is broad concerning any part of the nervous system, and they represent 10% of circumstances of HIV diagnosis (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHighly active antiretroviral treatments (HAART) have contributed reduce the spread of infection, but the frequency of HIV-related neurological complications remains high. Delayed diagnosis of HIV-related neurological complications have an impact on patient outcome (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). In Cameroon, HIV-related neurological complications represent the most common cause of CNS infections (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). In 1986, the initial response of the Cameroon government to the increasing trends in the HIV/AIDS infection was to create a National AIDS Control Committee to coordinate a national AIDS program (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Since that period, several strategies have been implemented to reduce the prevalence of HIV and opportunistic infections. In 2018, the State of Cameroon adopted the \"Test and Treat\" strategy, the aim of which was to treat newly diagnosed HIV-positive patients directly, regardless of their CD4 count (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). It seems important to us to evaluate the frequency and outcome of neurological complications of HIV during this era.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eStudy design and setting:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe conducted a retrospective cohort study in the internal medicine departments of the Laquintinie hospital of Douala (LHD) and the Douala General Hospital (DGH). We reviewed the data of patients diagnosed of HIV from January 1\u003csup\u003est\u003c/sup\u003e, 2016, to December 31\u003csup\u003est\u003c/sup\u003e, 2023. These two health facilities are the main teaching and referral hospitals in the city of Douala (economic hub of Cameroon). These health facilities comprise HIV treatment centers, neurology units, imaging centers, and central laboratories. In both hospitals, imaging centers include CT scan and MRI, while central laboratories perform basic CSF analysis to identify common bacterial germ, cryptococcus neoformans, soluble antigens. The polymerase chain reaction (PCR) for Mycobacterium tuberculosis in CSF sample is freely available at the Regional Delegation for Public Health located in the administrative center of the city.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eData collection:\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe collected data of patients followed up for HIV-related neurological complications. Incomplete medical records were excluded. We documented:\u0026nbsp;\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eDemographic characteristics: age, sex, occupation, marital status, residence, education level.\u003c/li\u003e\n \u003cli\u003eClinical features: history of chronic infections (e.g. tuberculosis) or comorbidities (e.g. hypertension, diabetes mellitus), general signs, Glasgow coma scale (GCS), neurological and systemic examination, WHO clinical stage of HIV.\u003c/li\u003e\n \u003cli\u003eParaclinical investigations: CD4 count (per mm\u003csup\u003e3\u003c/sup\u003e), viral load (detectable and undetectable), CSF analysis, neuroimaging (brain CT scan/MRI) findings.\u003c/li\u003e\n \u003cli\u003eEtiologies of HIV-related neurological complications: cerebral toxoplasmosis, cryptococcal meningitis, tuberculous meningitis, HIV encephalitis, stroke, progressive multifocal leukoencephalopathy, myelitis, \u0026hellip;\u003c/li\u003e\n \u003cli\u003eTreatment details: HAART regimen, delay in HAART initiation, change in HAART regimen, opportunistic infection prophylaxis.\u003c/li\u003e\n \u003cli\u003eOutcome: hospitalization and mortality.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eStatistical analysis\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were collected and analyzed using Epi info software version 7.2.1.0. In the descriptive statistics, continuous variables were expressed as mean (standard deviation), and categorical variables were presented as frequency (percentage). Chi-square test was used to compare categorical variables. We performed a univariate and multivariate logistic regression models to identify associated and predictive factors of in-hospital mortality in patients with HIV-related neurological complications. The significance threshold was set at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical considerations:\u0026nbsp;\u003c/strong\u003eEthical approval was obtained from the Institutional Ethics Committee of the University of Douala (N\u0026deg;4140/CEI-UDo/04/2024/T). This research was conducted in accordance with the ethical standards of the Institutional Ethics Committee of the University of Douala and the Declaration of Helsinki.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eAmong 15,521 admissions in internal medicine departments of these hospitals, 1,058 (6.8%) were people living with HIV (PLHIV) including 435 (41.1%) admission for HIV-related neurological complications (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The mean age of patients was 45.5 (11.7) years and women accounted for 58.4% of cases. Newly diagnosed PLHIV represented 26.9% of patients. Altered mental status (18.8%), motor weakness (18.1%), and headaches (17.5%) were the main complaints. 64.8% of patients were WHO clinical stage IV. A CD4 count and viral load were not available in 85% and 86.7% respectively (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic and clinical characteristics of patients with HIV-related neurological complications.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" 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\u003cp\u003e58.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eJob\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e260\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e59.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e175\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e40.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnmarried couple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e23.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrevious neurological diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiabetes mellitus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeurological complaints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAltered mental status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMotor weakness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHeadaches\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeizures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDelirium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpeech disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSleep disorders\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNon-neurological complaints\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAltered general status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiarrhea and vomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHO clinical stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e25.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eStage IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4 count (per mm3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200\u0026ndash;500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndetermined\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e85.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eViral load\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndetectable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDetectable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndetermined\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e86.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVirus sub-type\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eType 1 HIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e226\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eType 2 HIV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHIV 1\u0026thinsp;+\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUntyped\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e48.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe most common etiologies of HIV-related neurological complications were cerebral toxoplasmosis (33.3%), meningoencephalitis of undetermined cause (25.3%), and cryptococcal meningitis (9.2%), see Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. In this study, 64.2% of patients were on first-line ART, particularly TDF/3TC/TDG. ART had not yet been initiated in 26.9% (n\u0026thinsp;=\u0026thinsp;117) of patients. At least 75% (n\u0026thinsp;=\u0026thinsp;327) of patients were not on sulfamethoxazole/trimethoprim prophylaxis.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEtiologies of HIV-related neurological complications.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebral toxoplasmosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e145\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeningoencephalitis of undetermined cause\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCryptococcal meningitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIschemic stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHIV encephalitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemorrhagic stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrain tumor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculous meningitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEpilepsy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProgressive Multifocal Leukoencephalopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSub-arachnoid hemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCompressive myelopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrain abscess\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePeripheral neuropathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMigraine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe in-hospital mortality rate was 29.4%, and the mean length of hospital stay was 39.18\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2 days (median 6.5; interquartile range 3\u0026ndash;12 days). The most common causes of death were meningoencephalitis of undetermined etiology (56.3%), cerebral toxoplasmosis (25.8%) and cryptococcal meningitis (8.6%), Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of HIV-related neurological complications among deceased patients\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeningoencephalitis of unknown etiology\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebral toxoplasmosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e25.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCryptococcal meningitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculous meningitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemorrhagic stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProgressive Multifocal Leukoencephalopathy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSub-arachnoid hemorrhage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIschemic stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003eTotal number of deceased: 128\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eAnalytical study and search for associated factors\u003c/h3\u003e\n\u003cp\u003eIn univariate analysis, lack of HAART (OR: 26.58, 95%CI:15.27\u0026ndash;46.28, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), undetermined viral load (OR: 6.46, 95%CI:1.51\u0026ndash;27.55, p\u0026thinsp;=\u0026thinsp;0.004), cerebral toxoplasmosis (OR: 2.88, 95%CI:1.13\u0026ndash;7.37, p\u0026thinsp;=\u0026thinsp;0.027), and meningoencephalitis of unknown etiology (OR: 9.10, 95%CI:5.59\u0026ndash;14.81, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly associated with in-hospital mortality among patients with HIV-related neurological complications (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Multivariate logistic regression identified cerebral toxoplasmosis (aOR:4.57, 95%CI:1.59\u0026ndash;13.17, p\u0026thinsp;=\u0026thinsp;0.005) and meningoencephalitis of unknown etiology (aOR: 1.78, 95%CI:1.03\u0026ndash;3.06, p\u0026thinsp;=\u0026thinsp;0.038) as independent predictors of death in this cohort (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociated and predictive factors of death among patients with HIV-related neurological complications.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDeaths n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSurvivors n (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eaOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e95%CI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003ep-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDemographics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u0026thinsp;\u0026ge;\u0026thinsp;46 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63 (46.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e72 (53.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.84\u0026ndash;2.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.217\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.99\u0026ndash;2.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79 (43.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e101 (56.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.70\u0026ndash;1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.636\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.62\u0026ndash;1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.901\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHypertension\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (65.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.33\u0026ndash;1.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.32\u0026ndash;1.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.256\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTuberculosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17 (51.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63\u0026ndash;2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.485\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.62\u0026ndash;2.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.444\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTX-TMP prophylaxis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e70 (64.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eREF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e90 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e237 (72.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.90\u0026ndash;2.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.851\u0026ndash;2.428\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.175\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHAART\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37 (11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e281 (88.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eREF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91 (77.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26 (22.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.27\u0026ndash;46.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlasgow coma scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70 (58.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49 (47.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eREF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.12\u0026ndash;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e9\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25 (10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e215 (89.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.05\u0026ndash;0.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33 (43.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43 (56.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.30\u0026ndash;0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.036\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCD4 count (per mm\u003csup\u003e3\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e144 (55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eREF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (72.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (27.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.21\u0026ndash;1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.19\u0026ndash;0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eViral load\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndetectable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (93.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eREF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDetectable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7 (25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.88\u0026ndash;24.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.054\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndetermined\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e119 (31.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e258 (68.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.51\u0026ndash;27.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.19\u0026ndash;1.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.223\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWHO Stage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage I\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (81.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eREF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage II\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3 (5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27 (94.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.07\u0026ndash;3.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.478\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage III\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19 (17.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e93 (83.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.18\u0026ndash;4.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.918\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStage IV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104 (36.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178 (63.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.56\u0026ndash;12.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.90\u0026ndash;19.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.068\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEtiologies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCerebral toxoplasmosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33(22.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112 (77.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.13\u0026ndash;7.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.42\u0026ndash;11.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeningoencephalitis (UE)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72 (65.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38 (34.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.59\u0026ndash;14.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.03\u0026ndash;3.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.038\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCryptococcal meningitis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (27.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29 (72.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.30\u0026ndash;4.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.843\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.41\u0026ndash;8.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.410\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIschemic stroke\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(5.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35(94.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.03\u0026ndash;0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e--\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eHAART: highly active antiretroviral treatment; STX-TMP: sulfamethoxazole-trimethoprim, UE: unknown etiology.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study aimed to determine prevalence of HIV-related neurological complications and identify factors associated with in-hospital mortality among patients in two referral hospitals in Douala.\u003c/p\u003e \u003cp\u003eWe observed that over 40% of PLHIV admitted during the study period presented with neurological complications of HIV (neuro-HIV), with cerebral toxoplasmosis accounting for one-third of cases. More than 85% of patients lack CD4 count or viral load measurements, reflecting limited immunological and virological monitoring.\u003c/p\u003e \u003cp\u003eThe prevalence of HIV in our hospital cohort aligns with that reported by Gams et al. in 2022, ranging from 2.2% to 2.6% (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Similarly, the proportion of neuro-HIV cases mirrors the 44.6% reported by Luma et al. in 2013 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Millogo et al. and Djagadou et al. found respectively a prevalence of neurological disorders in HIV of 14.7% and 15.1% (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). This difference could be explained by the fact that the cases in the study were recruited over a short period and on a smaller sample. Furthermore, the study carried out in Burkina Faso by Millogo et al. showed that in 40\u0026ndash;75% of cases, neurological manifestations occur during the AIDS phase, and in 10% of cases they are the first signs of infection(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The latest national HIV prevalence figures from the Demographic Health Survey (EDS 2018) were 2.7% for the 15\u0026ndash;49 age group, with over 40% of PLHIV presenting neuro-HIV (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe mean age of patients in our cohort is consistent with several African series (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e), though slightly older than populations reported by Adoukonou et al. ( 2015) and Apetse et al. (2015) (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Female represented the majority of cases, similar to Rolland et al., reflecting the feminization of the HIV epidemic in Sub-Saharan Africa, where women account for 53% to 61% of adults living with HIV (\u003cem\u003eJoint United Nations Programme on HIV/AIDS (UNAIDS\u003c/em\u003e), 2024) (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). This is further corroborates by the results of the Demographic and Health Survey (DHS) in Cameroon, showing HIV prevalence of 5.6% in women versus 2.9% in men (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAltered mental status, motor weakness, and headaches were the most common presenting complaints, consistent with findings by Rolland et al., and Gams et al., (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Cerebral toxoplasmosis, meningoencephalitis and cryptococcal meningitis were leading etiologies in line with previous reports by Luma et al., (2013) and Gams et al., (2022) (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). These data align with reports from several studies of neuro-HIV (\u003cspan additionalcitationids=\"CR23 CR24\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). These observations underscore the frequent central nervous system involvement in HIV, likely driven by both immunosuppression induced by the virus, and direct viral neurotoxicity. The high proportion of patients without CD4 count and viral load testing may reflects the Cameroon\u0026rsquo;s national \u0026ldquo;Test and Treat\u0026rdquo; strategy, which recommend to initiate the HAART to newly diagnosed PLVIH, regardless of immunological and virological parameters (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Or may also indicates current limitations in immunological and virological assessments.\u003c/p\u003e \u003cp\u003eIn our cohort, the in-hospital mortality rate of 29.4% is slightly higher to that reported by Gams et al., (23.5%) in people with central nervous system infections with and without HIV (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). This likely reflects the substantial contribution of HIV to adverse outcomes in central nervous system infections. Higher mortality rates were observed by Traor\u0026eacute; et al., and D\u0026eacute;gu\u0026eacute;nonvo et al., (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). This were likely influenced by limited hospital resources, delayed consultations, and socioeconomic barriers (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). The implementation of free healthcare HIV programs in Cameroon over the past decades appears to have contributed to reduce mortality, from 49% reported by Luma et al., (2013) to less than 30% in the current cohort (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnalytical statistics revealed that cerebral toxoplasmosis and meningoencephalitis of unknown etiology were independent predictors of death. Univariate analysis also highlighted the contribution of the absence of HAART and undetermined viral load to in-hospital mortality. This underscores the importance of early HAART initiation, timely diagnosis, and systematic management of neurological complications of HIV. Comparable observations have been reported by other studies who identified advanced WHO stage, absence of HAART, delayed consultation, and meningoencephalitis of unknown etiology as significant predictive factors of mortality (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Furthermore, Luma et al. found low CD4 cell count strongly associated with death (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). This shows that challenges in the monitoring of PLHIV can lead to death. Collectively, these data highlight that delay in monitoring and managing PLVIH significantly contribute to mortality from neuro-HIV.\u003c/p\u003e \u003cp\u003eDespite the crucial findings, this study has several limitations. Its retrospective design relies on the completeness of medical records, introducing potentials information and selection bias, particularly with the exclusion of incomplete medical files. The high proportion of missing immunological and virological data such as CD4 count and viral load measurement limited our ability to assess immune status and its relationship with outcomes. Diagnostic constraints such as limited access to MRI, and advanced CSF analysis likely contributed to substantial number of cases classified as meningoencephalitis of unknown etiology. In addition, we were unable to evaluate HAART adherence, timing of symptom onset, and variations in clinical management across sites. As the study was conducted in two referral hospital in an urban area, these finding could not be generalized to the entire population of PLHIV in Cameroon.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eHIV-related neurological complications remain a major cause of mortality and morbidity, with cerebral toxoplasmosis and meningoencephalitis of unknown etiology emerging as predictors of in-hospital death. The high burden of severe disease, late clinical presentation, limited availability of immunological and virological assessment, and lack of advanced diagnostic testing underscore the challenges in the management of neuro-HIV. Strengthening early HIV diagnosis, improve routine immunovirological monitoring, ensuring timely access to neuroimaging and CSF diagnostics, reinforcing adherence to HAART, and prophylactic regiment are essential to reduce mortality. Prospective studies with comprehensive diagnostic approach could better identify etiologies and improve outcomes for patients with HIV-related neurological complications in a resource-limited setting.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe sincerely express our gratitude to the administrative board and medical archives departments of Douala Laquintinie and Douala General Hospital for their assistance in assessing patients records and facilitating data retrieval. Their support was essential to the successful completion of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor’s contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAMM: conceptualization, data collection, data analysis, manuscript drafting.\u003c/p\u003e\n\u003cp\u003eDGM: study design, methodology, data interpretation, critical manuscript revision.\u003c/p\u003e\n\u003cp\u003eVDPM: data collection, clinical assessment, manuscript drafting.\u003c/p\u003e\n\u003cp\u003eJIID: data analysis and interpretation, critical manuscript revision.\u003c/p\u003e\n\u003cp\u003eVS: data interpretation, critical manuscript revision.\u003c/p\u003e\n\u003cp\u003eCKT: supervision, critical manuscript revision.\u003c/p\u003e\n\u003cp\u003eNYM: supervision, conceptualization, data interpretation, critical manuscript revision.\u003c/p\u003e\n\u003cp\u003eAll authors reviewed the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they received no specific funding for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset used during this study are available from the corresponding authors on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval for this study was obtained from the Institutional Ethics Committee of the University of Douala (N°4140/CEI-UDo/04/2024/T). As this was a retrospective review of medical records, the requirement of informed consent was waived. All data were anonymized to ensure confidentiality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGalvani AP, Pandey A, Fitzpatrick MC, Medlock J, Gray GE. Defining control of HIV epidemics. Lancet HIV. nov 2018;5(11):e667‑70. \u003c/li\u003e\n\u003cli\u003eHIV.gov [Internet]. [cit\u0026eacute; 29 oct 2024]. HIV and AIDS Epidemic Global Statistics. Disponible sur: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics\u003c/li\u003e\n\u003cli\u003eBell JE. The neuropathology of adult HIV infection. Rev Neurol (Paris). d\u0026eacute;c 1998;154(12):816‑29. \u003c/li\u003e\n\u003cli\u003eEggers C, Arendt G, Hahn K, Husstedt IW, Maschke M, Neuen-Jacob E, et al. 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African Journal of Neurological Sciences [Internet]. 2007 [cit\u0026eacute; 30 oct 2024];26(1). Disponible sur: https://www.ajol.info/index.php/ajns/article/view/7588\u003c/li\u003e\n\u003cli\u003eFortes D\u0026eacute;gu\u0026eacute;nonvo L, Manga NM, Diop SA, Dia Badiane NM, Seydi M, Ndour CT, et al. Current profile of HIV-infected patients hospitalized in Dakar (Senegal). Bull Soc Pathol Exot. 1 d\u0026eacute;c 2011;104(5):366‑70. \u003c/li\u003e\n\u003cli\u003eAdoukonou T, Dassi-Gbenou J, Glele RA, Dovonou A, Kpangon A, Houinato D. \u0026Eacute;pid\u0026eacute;miologie des affections neurologiques dans une population de personnes vivant avec le VIH \u0026agrave; Parakou en 2014. Revue Neurologique. 1 avr 2015;171:A136. \u003c/li\u003e\n\u003cli\u003eRolland OIB, Obengui, B\u0026eacute;bene DB, Macaire ONP, Herdan P, Claude BPJ, et al. Affections Neurom\u0026eacute;ning\u0026eacute;es Au Cours Du VIH Dans Le Service Des Maladies Infectieuses Du CHU De Brazzaville : Pr\u0026eacute;valence Et Facteurs Associ\u0026eacute;s Au D\u0026eacute;c\u0026egrave;s. European Scientific Journal, ESJ. 30 nov 2016;12(33):177‑177. \u003c/li\u003e\n\u003cli\u003eMapoure YN, Nkongni IN, Luma HN, Ngahane BHM, Barla E, Ngwane S, et al. Incidence des accidents vasculaires c\u0026eacute;r\u0026eacute;braux chez les patients VIH positifs sous traitement antir\u0026eacute;troviral au long court. The Pan African Medical Journal. 11 mai 2016;24:45. \u003c/li\u003e\n\u003cli\u003eMoulignier A. Atteintes du syst\u0026egrave;me nerveux central et infection par le VIH-1. Revue Neurologique. 1 janv 2006;162(1):22‑42. \u003c/li\u003e\n\u003cli\u003eStahl JP, Mailles A, Vaillant V, Floret D. Les enc\u0026eacute;phalites infectieuses aigu\u0026euml;s : recommandations pour un diagnostic \u0026eacute;tiologique. R\u0026eacute;animation. 1 oct 2007;16(6):485‑9. \u003c/li\u003e\n\u003cli\u003eBoucher J, Tard C, Defebvre L. Leucoenc\u0026eacute;phalopathie multifocale progressive chez une patiente immunocomp\u0026eacute;tente. Pratique Neurologique - FMC. 1 sept 2014;5(3):209‑13. \u003c/li\u003e\n\u003cli\u003eTraor\u0026eacute; FA, Cissoko Y, Tounkara TM, Sako FB, Mouelle AD, Kpami DO, et al. [Causes of lymphocytic meningitis in people with HIV admitted to the Infectious Disease department of Conakry]. Med Sante Trop. 2015;25(1):52‑5. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"HIV-related neurological complications, CD4 count, viral load, meningoencephalitis of unknown etiology, cerebral toxoplasmosis, mortality","lastPublishedDoi":"10.21203/rs.3.rs-8213367/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8213367/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eNeurological complications are common in HIV infection and can occur at any stage of the disease. These conditions could be associated with poor outcome. This study aimed to determine the prevalence of HIV-related neurological complications and to identify factors associated with mortality among these patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and method: \u003c/strong\u003eThis was a retrospective cohort study from January 1\u003csup\u003est\u003c/sup\u003e, 2016, to 31 December 31\u003csup\u003est\u003c/sup\u003e, 2023, in Laquintinie and General hospitals in Douala. We reviewed all patient with HIV records, and we included those with HIV-related neurological complication. Demographic, clinical, laboratory, neuroimaging, and therapeutic data were collected. Univariate and multivariate logistic regression analysis were performed to identify predictive factors of mortality.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eAmong 15,521 admission, 1,058 (6.8%) were PLHIV, including 435 (41.1%) with HIV-related neurological complications. The mean age was 45.5±11.7 years, and 58.4% were women. CD4 count and viral load were unavailable in more than 85% of cases. Cerebral toxoplasmosis (33.3%), meningoencephalitis of undetermined etiology (25.3%), and cryptococcal meningitis (9.2%) were the most common etiologies. The overall mortality rate was 29.4%. \u0026nbsp;In multivariate analysis, cerebral toxoplasmosis (aOR:4.57, 95%CI:1.59 – 13.17, p=0.005), and meningoencephalitis of unknown etiology (aOR: 1.78, 95%CI:1.03–3.06, p=0.038) were independent predictors of death.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eHIV-related neurological complications remain common and deadly in our setting, with cerebral toxoplasmosis and meningoencephalitis of unknown etiology emerge as major contributors to mortality. Limited access to immunovirological and advanced diagnostic testing likely contribute to delayed diagnosis and poor outcomes. Prospective studies are needed to refine diagnostic algorithm and improve survival in affected patients.\u003c/p\u003e","manuscriptTitle":"HIV-related neurological complications in Cameroon in the era of Test and Treat strategy: prevalence and mortality","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-22 08:31:46","doi":"10.21203/rs.3.rs-8213367/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-02-12T09:19:14+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-06T21:46:07+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-02-01T22:51:03+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-01-30T17:42:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"44151645668902989415417709585210634537","date":"2026-01-28T12:48:05+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"117929369165707212758102048934398772725","date":"2026-01-27T16:57:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"157808848528239540610302134412295597747","date":"2026-01-22T13:39:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"222213657981253564264543998696193739816","date":"2026-01-21T00:36:19+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"303397620504406977876961026394790920857","date":"2026-01-20T16:48:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-01-20T12:51:14+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-12-08T10:32:36+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-12-05T05:23:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-12-05T05:22:30+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-11-26T13:05:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"62cd5118-aaf3-403a-8c56-a341a6b933ee","owner":[],"postedDate":"January 22nd, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-05-04T16:10:27+00:00","versionOfRecord":{"articleIdentity":"rs-8213367","link":"https://doi.org/10.1186/s12879-026-13430-3","journal":{"identity":"bmc-infectious-diseases","isVorOnly":false,"title":"BMC Infectious Diseases"},"publishedOn":"2026-04-29 15:57:19","publishedOnDateReadable":"April 29th, 2026"},"versionCreatedAt":"2026-01-22 08:31:46","video":"","vorDoi":"10.1186/s12879-026-13430-3","vorDoiUrl":"https://doi.org/10.1186/s12879-026-13430-3","workflowStages":[]},"version":"v1","identity":"rs-8213367","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8213367","identity":"rs-8213367","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}