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Abstract Details

Clinical Characteristics and Outcomes of Neurocysticercosis in Adults with HIV in Zambia
Infectious Disease
S25 - Diagnostics and Therapeutics in Infectious Disease (5:06 PM-5:18 PM)
009

Neurocysticercosis (NCC) is a parasitic disease of the central nervous system caused by Taenia solium, commonly presenting with seizures. It is endemic in Zambia which also has a high rate of HIV. Whether or not HIV has an influence on the presentation and outcome of NCC is unknown.

Compare clinical characteristics and outcomes between people with HIV (PWH) and neurocysticercosis (NCC)  and HIV-uninfected adults with NCC.

A prospective longitudinal cohort study of adults (>18 years) diagnosed with NCC at the University Teaching Hospital in Lusaka, Zambia was conducted between December 2021 and October 2023. The diagnosis of NCC was made on routine head CT or MRI. Interviews and chart reviews of consenting participants were conducted to obtain HIV status, clinical features and vital status at discharge. Vital status and seizure status were obtained by follow-up phone interviews at 12 months post-discharge.

During the study period, 71 participants were recruited, of whom 17% (n=12) were PWH. The mean age of PWH was 47 (SD16) years compared to 38 (SD12) years among HIV-uninfected participants (p=0.03). Twelve-month follow-up data were available in 49 (69%) of participants, including 11 (92%) of PWH and 38 (64%) of HIV-uninfected participants.   Twelve-month mortality was 36% (n=4/11) among PWH and 3% (n=1/38) among participants without HIV (p=0.007). There were no other significant differences in demographic, radiological, or clinical characteristics between PWH and participants without HIV.

Mortality is significantly higher in PWH and NCC than in HIV-uninfected adults with NCC in Zambia, and NCC occurs at older ages amongst PWH. Whether mortality is due to NCC itself or to other AIDS-related processes requires further investigation.  More work is required to further understand the relationship between HIV and NCC in endemic countries such as Zambia.

Authors/Disclosures
Mashina Chomba (University of Zambia)
PRESENTER
Dr. Chomba has nothing to disclose.
Melody Asukile (University Teaching Hospital) Dr. Asukile has received research support from Royal Society for Tropical Medicine and Hygiene. Dr. Asukile has received personal compensation in the range of $0-$499 for serving as a meeting speaker with American Neurological Association.
David Bearden (University of Rochester School of Medicine) Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Bearden has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for law firms.
Frighton Mutete (Livingstone University Teaching Hospital) Dr. Mutete has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Theresa Shankanga (University of Zambia, ridgeway campus) Miss Shankanga has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Deanna Saylor (Johns Hopkins Hospital) The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from National Multiple Sclerosis Society. The institution of Dr. Saylor has received research support from American Academy of Neurology. The institution of Dr. Saylor has received research support from United States Department of State. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and Educational Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.