Highlights
- •Cerebral venous thrombosis in HIV seropositive individuals is rare.
- •HIV infection itself forms a procoagulant condition in CVT.
- •Elevated homocysteine, low B12 forms an important etiological factor in CVT.
Abstract
Background
HIV infection has been found to be prothrombotic condition. However, venous thromboembolism
associated with HIV is restricted to peripheral vasculature with few reports of cerebral
venous thrombosis (CVT).
Objective
To examine the clinical manifestations of CVT among HIV seropositive individuals and
explore the possible etiological factors.
Methods and results
It is a prospective study of 26 (M:F-18:8) patients of CVT associated with HIV seropositive
status. Their age and duration of illness was 33.8 ± 6.8 years and 11.3 ± 8.5 days respectively. Headache and vomiting was the most common symptom followed by seizures.
Drowsiness with GCS (Glasgow coma score) ranging from 9–14 was present in two-thirds
of the patients. Serum homocysteine was elevated in 70% of patients. Vitamin B12 was
low in 12.5% and insufficient levels in 25%. 88.5% of the patients recovered completely
to GCS 15/15 in 2–7 days during follow up; 11.5% patients expired during the acute state.
Conclusion
This study represents the largest series of CVT in HIV seropositive individuals. There
is increased risk of thrombosis due to elevated homocysteine and low Vitamin B12.
They have better sensorium inspite of extensive radiological involvement.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Profile of neurological disorders associated with HIV-AIDS from Bangalore, South India (1989–96).Indian J. Med. Res. 2000; 111: 14-23
- Seizures in HIV-seropositive individuals: NIMHANS experience and review.Epilepsia. 2008; 49: 33-41
- HIV-associated venous thromboembolism.Mediterr. J. Hematol. Infect. Dis. 2011; 3: e2011030
- Venous thrombosis in HIV infection.Int. J. STD AIDS. 1996; 7: 82-85
- Risk of venous thromboembolism in patients infected with HIV: a cohort study.Int. J. Angiol. 2013; 22: 95-100
- Nonopportunistic neurological manifestations of the human immunodeficiency virus: an Indian study.J. Int. AIDS Soc. 2005; 7: 2
- Deep venous thrombosis and megesterol in patients with HIV infection.AIDS. 1999; 13: 1425-1426
- Cerebral Venous Thrombosis and dual primary infection with human immunodeficiency virus and cytomegalovirus.J. Neurol. Neurosurg. Psychiatry. 1989; 52: 1010-1011
- HIV infection presenting as cerebral venous sinus thrombosis.Am. J. Emerg. Med. 2012; 30: e1-e3
- Ramsay-hunt syndrome complicated with cerebral venous thrombosis in an HIV-1 infected patient.Enferm. Infect. Microbiol. Clin. 2007; 25: 69-70
- Thrombosis of the superior longitudinal sinus in patients with AIDS. A review of the literature.Rev. Neurol. 1997; 25: 247-249
- Markers of coagulation and inflammation often remain elevated in ART-treated HIV-infected patients.Curr. Opin. HIV AIDS. 2014; 9: 80-86
- Cerebral venous sinus thrombosis in HIV-infected patients: report of 2 cases.Pan Afr. Med. J. 2013; 16: 4
- AIDS and thrombosis: retrospective study of 131 HIV-infected patients.AIDS Patient Care STDs. 2001; 15: 311-320
- Is chronic HIV infection associated with venous thrombotic disease? A systematic review.Neth. J. Med. 2005; 63: 129-136
- Cerebral venous thrombosis: an Indian perspective.Neurol. India. 2015; 63: 318-328
- Thromboses among HIV-infected patients during the HAART era.AIDS Patient Care STDs. 2008; 22: 771-778
- The characteristics of HIV and AIDS patients with deep vein thromboses at Dr. George Mukhari academic hospital.Afr. J. Prim. Health Care Fam. Med. 2015; 7
- Risk factors, clinical profile, and long-term outcome of 428 patients of cerebral sinus venous thrombosis: insights from Nizam’s Institute Venous Stroke Registry, Hyderabad (India).Neurol. India. 2012; 60: 154-159
- Cerebral venous thrombosis.J. Assoc. Physicians India. 1987; 35: 349-351
- Prognosis of cerebral vein and dural sinus thrombosis: results of the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT).Stroke. 2004; 35: 664-670
- Cerebral venous thrombosis: a descriptive multicentre study of patients in Pakistan and Middle East.Stroke. 2008; 39: 2707-2711
- Unusual thromboses associated with protein S deficiency in patients with acquired immunodeficiency syndrome: case reports and review of the literature.AIDS Res. Hum. Retrovir. 2005; 21: 753-756
- Low serum vitamin B12 levels in an outpatient HIV-infected population.Int. J. STD AIDS. 2004; 15: 127-133
- Homocysteine, vitamin B12, and folate in puerperal CVT.J. Neurol. Sci. 2008; 272: 43-47
- Swiss HIV cohort study.AIDS. 2001; 15: 1081-1082
- Warfarin-antiretroviral interactions.Ann. Pharmacother. 2009; 43: 322-328
- HIV and risk of venous thromboembolism: a Danish nationwide population-based cohort study.HIV Med. 2011; 12: 202-210
- Neurological complications in AIDS patients receiving HAART: a 2 year prospective study.Eur. J. Neurol. 2006; 13: 233-239
Article info
Publication history
Published online: April 21, 2017
Accepted:
April 17,
2017
Received in revised form:
April 10,
2017
Received:
February 21,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
