Guillain-Barre Syndrome Common in HIV Positive Women – Study Finding
The Guillain-Barre Syndrome (GBS) occurs commonly in young HIV positive women, a study by a Master of Medicine graduate has found.
The study was conducted by Dr Ansuya Naidoo, a lecturer in UKZN’s School of Clinical Medicine and Consultant Neurologist at Greys Academic Hospital in Pietermaritzburg.
GBS, also known as Acute Inflammatory Demyelinating Polyneuropathy (AIDP), is a primarily demyelinating polyradiculo-neuropathy, characterised by rapidly evolving symmetrical limb weakness which overshadows sensory symptoms and signs.
‘The purpose of this study was to review all cases of GBS admitted to tertiary neurology referral centres at Inkosi Albert Luthuli Memorial Hospital in Durban and Greys Hospital in Pietermaritzburg over a seven-year period,’ said Naidoo. ‘We aimed to compare the epidemiological, clinical, biochemical, and neurophysiological features between the subgroups of HIV associated GBS (HIV positive) and non-HIV associated GBS (HIV negative).’
The study found that sensory symptoms and signs predominate in HIV-associated GBS which is more prone to developing axonal variants of GBS.
‘HIV-associated GBS presents with higher CSF protein levels than previously described and a CSF pleocytosis does not persist in the presence of HIV- associated GBS. HIV-associated GBS occurred at lower CD4 counts than previously described. Non-HIV associated GBS patients display a better recovery and lower mortality,’ said Naidoo.
Naidoo says the study enables a better understanding of the clinical picture of GBS in HIV positive versus negative patients.
It was titled: “A Retrospective Study of Epidemiological Data, Clinical Presentation, Neurophysiological Features and Laboratory Features of Patients with Guillain-Barre Syndrome (GBS) Admitted to Two Tertiary Neurology Referral Centres in KwaZulu-Natal, South Africa”.
Naidoo believes the study is novel and will help in the early clinical detection and treatment of the condition and thus improve recovery outcomes.
‘The association between HIV infection and GBS has been well described. Although multiple worldwide reports of the syndrome exist, there has been no large systematic study of GBS comparing the characteristics of HIV- associated and non-HIV associated GBS performed in the South African setting.’
She said it was uncertain whether a distinct pattern of the syndrome existed in HIV associated GBS. ‘This study aims to better delineate this.’
She said 72 patients, 39 of whom were HIV positive, with a final diagnosis of GBS were identified. HIV status was known in 59 patients. The mean age of the cohort was 34 years (range 12 -76). In the HIV-associated GBS group, 60% of patients were female and in the non-HIV associated GBS group, 27% were female.