Current epidemiological and etiological characteristics and treatment of seizures or epilepsy in patients with HIV infec
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Yu et al. Acta Epileptologica (2020) 2:18 https://doi.org/10.1186/s42494-020-00028-8
REVIEW
Open Access
Current epidemiological and etiological characteristics and treatment of seizures or epilepsy in patients with HIV infection Changhao Yu1, Dong Zhou2, Weijia Jiang3 and Jie Mu2*
Abstract Seizures or epilepsy is one of the common serious complications in patients with advanced human immunodeficiency virus (HIV) infection or diagnosed with immune deficiency syndrome, with higher incidence and prevalence than in the general population. Generalized seizures are the most common type in the patients. Opportunistic infections are a stereotypical predisposing factor for seizures in HIV patients, but a variety of pathogenic factors can also be found in these patients, such as metabolic perturbation and drug-drug interactions. The diagnostic criteria for seizures in these patients are the same as those in the general population. As HIV patients with seizures need to take both antivirals and antiepileptic drugs, the risk of drug-drug interactions is greatly increased, and the side effects of drugs may also become more prominent. At present, most experience in antiepileptic drug usage has come from the general population, and there is still a lack of guidance of antiepileptic drug use in special groups such as the HIV-infected people. Unlike the old-generation drugs that involve metabolisms through CYP450, the first-line antiepileptic drugs usually bypass CYP450, thus having less drug-drug interactions. In this review, we summarize the recent research progress on the above-mentioned widely discussed topics and make a prospect on future research direction. Keywords: HIV, Seizure, Epilepsy, Opportunistic infection, Antiepileptic drug
Background Patients living with advanced human immunodeficiency virus (HIV) infection or diagnosed with acquired immune deficiency syndrome (AIDS) usually have complications related to the central nervous system (CNS), which may include psychiatric disorders, encephalitis, cerebrovascular diseases, etc. [1–3]. Seizures or epilepsy is a serious type of complication. Patients with witnessed seizures need long-term periodic medication control, making it a challenge for clinical drug management. In pediatric patients living with HIV, seizures or epilepsy may be concurrent with brain development delay or neuron-cognitive impairment [4]. Besides, HIV* Correspondence: [email protected] 2 Neurology Department, West China Hospital of Sichuan University, 14# Third Section, Renmin Nan Road, Chengdu 610041, China Full list of author information is available at the end of the article
seropositive patients with documented seizures are at a higher risk of developing other CNS syndromes, compared with the HIV-negative patients [5]. Among these patients, opportunistic infection (OI) as a result of deep immunosuppression is the most frequent cause; however, there is a considerable proportion of patients with no predominant causes, suffered from HIV encephalopathy (HIVE). Another part of patients has seizu
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