Actualités au cours de l'évolution de l'infection à VIH sida dans un centre de référence: à propos de 327 cas colligés dans le service de médecine interne du CHU de Bouake, Côte d'Ivoire / News during the evolution of HIV/AIDS infection in a reference center about 327 cases collected in the internal medicine department of the Bouake teaching hospital, Ivory Coast

Introduction : Les maladies opportunistes surviennent chez les personnes vivant avec le VIH (PvVIH) dans les situations de prise en charge tardive. En absence de traitements efficace, la multiplication du virus est inévitable et les personnes concernées sont confrontées à une baisse de leur immunité [1]. C'est dans cette situation que des infections opportunistes se déclarent. Objectif: contribuer à une meilleure connaissance des affections opportunistes liées au VIH Méthode : L'étude s'est déroulée dans le service de Médecine Interne du CHU de Bouaké du 1er janvier 2017 au 31 décembre 2020. C'était une étude rétrospective et transversale qui a concerné les dossiers de patients infectés par le VIH hospitalisés dans ledit service. Résultats : L'analyse a noté 327 cas de dossiers complets sur 3815. La prévalence hospitalière était de 8,5%. L'âge moyen était de 36,2 ans et le sex ratio de 0,83. 65,3% des patients n'ont découvert leur statut sérologique que pendant l'hospitalisation dont les motifs étaient dominés par l'altération de l'état général (36,8%) suivi du coma (19,2%). 84,5% des patients avaient le VIH1. Le taux moyen de CD4 était de 50,5% cellules/mm3 . Les affections opportunistes étaient dominées par la tuberculose (41,8% des cas) et la plus létale était la maladie de Kaposi digestif dans 100% des cas. Conclusion: les patients étaient hospitalisés au stade d'altération de l'état général et de coma d'où la forte létalité. La tuberculose était la principale affection opportuniste. Ces résultats montrent avec beaucoup d'intérêt l'importance de la sensibilisation de la population sur le VIH et la nécessité du dépistage précoce.

Introduction: Opportunistic diseases occur in people living with HIV (PvHIV) in situations of late treatment. In the absence of effective treatments, the multiplication of the virus is inevitable and the people concerned are confronted with a drop in their immune defenses [1, 2]. It is in this situation that opportunistic infections occur Objective: to contribute to a better understanding of opportunistic infections linked to HIV. Method: The study took place in the Internal Medicine department of the Bouake University Hospital from January 1, 2017 to December 31, 2020. It was a retrospective and cross-sectional study which concerned the files of patients infected with HIV hospitalized in the said department. Results: The analysis noted 327 cases of complete records out of 3815. The hospital prevalence of 8.5%. The mean age was 36 years and the sex ratio 0.83. 65.3% of patients only discovered their serological status during hospitalization, the reasons for which were dominated by deterioration in general condition (36%) followed by coma (19.2%). 84.5% of patients had HIV1. The average CD4 count was 50.5% cell/mm3. Opportunistic diseases were dominated by tuberculosis (38% of cases) and the most lethal was digestive Kaposi in 100% of cases. Conclusion: Most of our patients were without social security and did not know their HIV status. These patients were hospitalized at the stage of impaired general condition and coma, hence the high lethality observed. The main opportunistic infections were tuberculosis, cerebral toxoplasmosis and digestive mycoses. These results show with great interest the importance of sensitizing the general population on HIV AIDS and the need for early detection of these opportunistic diseases.

Profil clinique, immunologique et virologique des personnes vivant avec le VIH suivies au CHUD Oueme-Plateau / NA

Introduction : L'infection par le virus de l'immunodéficience humaine au (VIH) est une infection chronique caractérisée par la destruction progressive du système immunitaire par le virus. L'objectif de cette étude était de décrire le profil clinique, immunologique et virologique des personnes vivant avec le VIH et suivies au CHU Départemental Ouémé-Plateau de Porto-Novo. Méthodes : Il s'agissait d'une étude transversale et descriptive couvrant la période du 1er février 2016 au 1er mai 2016. Il a été procédé à un recrutement exhaustif de toutes les personnes vivant avec le VIH suivies en ambulatoire ou hospitalisées dans le Service de Médecine Interne du CHUD-OP, âgées d'au moins 15 ans et ayant donné leur consentement éclairé. Résultats : Au total 301 patients ont été inclus. L'âge moyen était de 42 ans ± 10,3 ans, avec des extrêmes de 19 ans et 74 ans. Les tranches d'âge les plus représentées étaient celle des 35 à 45 ans (118 patients soit 39,2%) et celle des 25 à 35 ans (72 patients soit 23,9%). Cette population était majoritairement féminine (73,1 %), soit une sex-ratio de 0,37. Les enquêtés, dans 79,4 %, étaient en couple. Le stade clinique 3 de l'OMS était prédominant (47,8%). Parmi les pathologies associées, l'hypertension artérielle était la plus fréquente (18.6%). Parmi ces patients, 300 (99,7 %) étaient porteurs de VIH 1. La charge virale a été réalisée chez 177 (58,8 %) patients et s'est révélée indétectable chez 117 patients soit 66,1 % des cas. La numération des CD4 a été réalisée chez 298 (99 %). Le nombre médian des CD4 était de 350 (Q1=206 ; Q3=504). Parmi les 301 PVVIH, 291 (96,68 %) étaient sous traitement antirétroviral. Conclusion : Cette population de personnes vivant avec le VIH est jeune et consulte tardivement

Introduction : Human immunodeficiency virus (HIV) infection is a chronic infection characterized by the progressive destruction of the immune system by the virus. The objective of this study was to describe the clinical, immunological and virological profile of people living with HIV and monitored at the Ouémé-Plateau Departmental University Hospital in Porto-Novo. Methods: This was a cross-sectional and descriptive study covering the period from February 1, 2016 to May 1, 2016. An exhaustive recruitment was carried out of all people living with HIV followed on an outpatient basis or hospitalized in the Service of Internal Medicine of the CHUD-OP, at least 15 years old and having given their informed consent. Results: A total of 301 patients were included. The mean age was 42 ± 10.3 years, with extremes of 19 and 74 years. The most represented age groups were that of 35 to 45 years (118 patients or 39.2%) and that of 25 to 35 years (72 patients or 23.9%). This population was predominantly female (73.1%), i.e. a sex ratio of 0.37. The respondents, in 79.4%, were in a relationship. WHO clinical stage 3 was predominant (47.8%). Among the associated pathologies, arterial hypertension was the most common (18.6%). Of these patients, 300 (99.7%) were carriers of HIV 1. Viral load was achieved in 177 (58.8%) patients and was undetectable in 117 patients, or 66.1% of cases. CD4 counts were performed in 298 (99%). The median CD4 count was 350 (Q1 = 206; Q3 = 504). Among the 301 PLHIV, 291 (96.68%) were on antiretroviral therapy. Conclusion: This population of people living with HIV is young and consults late.

Effects of HIV-1 and HIV-1/2 coinfection on patients with asymptomatic urinary tract infection attending HIV clinics in Benin City, Nigeria

Conflicting reports exist on the effect of HIV types on disease progression and relation to opportunistic infections. This study aims to determine the effect of HIV types on the prevalence and aetiologic agents of urinary tract infection (UTI). A total of 485 subjects consisting of 335 HIV patients and 150 non-HIV subjects without symptoms of UTI were recruited for this study. The HIV patients comprised of 251 on HAART and 84 HAART-naive patients. Blood and urine specimens were collected from all subjects. The blood specimens were used to determine HIV type and CD4 count while significant microbial isolates were recovered from the urine specimens and identified using standard techniques. Only HIV patients on HAART had significantly higher prevalence of asymptomatic UTI compared with non-HIV subjects (p=0.0234). However, comparing the prevalence of asymptomatic UTI of the various HIV types with that of non-HIV subjects, the results showed only HIV-1 to be significantly associated with asymptomatic UTI (p<0.05). CD4 count <200 cells/?L was not associated with UTI. Generally, Staphylococcus aureus was the most common aetiologic agent of UTI. Among HIV patients (both HAART-naive and those on HAART) with HIV-1, Staphylococcus aureus was the most common cause of UTI, while among those with HIV-1/2 dual infection, Escherichia coli predominated. HIV types have an effect on the prevalence and aetiologic agents of asymptomatic UTI

HIV-related disabilities: an extra burden to HIV and AIDS healthcare workers?

Background: Healthcare workers have been at the forefront of dealing with the impact of HIV and AIDS at all stages of the pandemic. This brings new challenges to include disability into HIV care. However; the implications for healthcare workers in an already fragile health system along with HIV-related disabilities in persons living with HIV are little understood. This study examined the healthcare workers' perspective on disability in HIV care.Method: This article describes a qualitative study using in-depth interviews with 10 healthcare workers in a semi-urban hospital setting in KwaZulu-Natal; South Africa. The study aimed to understand healthcare workers' experiences with disability in the context of HIV. The International Classification of Functioning Disability and Health (ICF) was used as a guiding framework to understand disability.Results: Healthcare workers described HIV-related disabilities on all three levels of disability; namely impairments/ body function; activity limitations and participation restrictions; as affecting the livelihood of their patients and household members. Issues also arose from disability and stigma that were perceived as affecting adherence to antiretroviral treatment. In addition; healthcare workers encounter challenges in dealing with the increased needs of care and support for those people living with HIV who experience HIV-related disabilities. They indicated a limited ability to cope and respond to these needs. Primarily they arrange additional referrals to manage complex or episodic disabilities. Participants also identified issues such as excessive work load; lack of resources and training and emotional challenges in dealing with disability. Conclusion: Healthcare workers need support to respond to the increased needs of people living with HIV who have HIV-related disabilities. Responses need to reflect: 1) increase in rehabilitative staff including in community outreach programmes; 2) skills training in HIV-related disability; and 3) psychosocial support for healthcare workers

Screening for opportunistic intestinal parasites in HIV/AIDS patients, attending the services of medical care in three different hospitals, Southern Ethiopia

Background and study aim: Diagnostic examination of stools for opportunistic intestinal parasites in HIV/AIDS patients is given less attention than it should be. The suspected opportunistic intestinal parasites such as Cryptosporidium parvum, Cyclospora cayentanensis, Toxoplasma gondii, Isospora belli and the symptom of explosive watery diarrhea they cause as well as others including Strongyloides stercoralis are the threat against the well-being of HIV/AIDS patients. The objective of this study is to demonstrate the indispensable necessity to free HIV/AIDS patients (who are under medical care in 3 different hospitals, Southern Ethiopia), from opportunistic intestinal parasites using diagnostic examination of stools followed by prompt curative treatment during every safety time interval. Patients and methods: Fresh stools samples from a total sample size of 710 HIV/AIDS patients were taken and examined in the parasitology laboratory, Dilla University, for the suspected intestinal opportunistic parasites. The methods employed to identify the intestinal parasites included observations in : wet mount, formalin-ether concentration technique, and permanent slide preparation as well as Baermann apparatus method for Strongyloides stercoralis. Result: Out of 710 HIV/AIDS patients examined 196 were found to be positive for 6 different species of the suspected intestinal parasites (infection rate of these parasites in the population of HIV/AIDS patients of the 3 different hospitals being The six species of parasites isolated from fresh stools samples were: Ascaris lumbricoides, Strongyloides stercoralis, Entameba histolytica, Giardia lamblia, Balantidium coli, and Trichuris trichiura. Conclusion: Reasonably planned successive safety time intervals must be attended continuously by HIV/AIDS patients without interruption to utilize the services of medical care in order to avoid/ neutralize the potential opportunistic infections and reinfections; otherwise, the fulminant death can turn to be true. The safety and well-being of those HIV-infected patients who attend all the medical services & advices provided by clinical experts is not different from that of HIV-noninfected individuals without any trace of exaggeration

Causes of Death in Hospitalized HIV Patients in the Early Anti-Retroviral Therapy Era

Objective: To establish the cause(s) of death among persons with HIV and AIDS admitted to the Fevers Unit of the Korle-Bu Teaching Hospital (KBTH) in 2007 and to determine whether they were AIDS-relatedin the era of availability of HAART Method: Retrospective chart review of all deaths that occurred in the year 2007 among inpatients with HIV infection. Cause of Death (COD) was established with post mortem diagnosis; where not available ICD-10 was reviewed independently by two physicians experienced in HIV medicine and a consensus reached as to the most likely COD. Results: In the year under review; 215 (97) of the 221 adult deaths studied were caused by AIDS and HIV-associated illnesses. Of these; 123 (55.7) were due to an AIDS-defining illness as described in CDC Category 3 or WHO stage 4. Infections accounted for most of the deaths 158 (71.5); many of them opportunistic 82 (51.8). Tuberculosis was the commonest COD. Clinical diagnosis of TB was accurate in 54 of deaths; but was not validated by autopsy in 36 of deaths. There were few deaths (14.5) in patients on HAART. Conclusion: In a developing country like Ghana where HAART was still not fully accessible; AIDS-related events remained the major causes of death in persons living with HIV. Total scale-up of the ART programme with continuous availability of antiretrovirals is therefore imperative to reduce deaths from AIDS and HIV associated illnesses. There is need for interventions for early diagnosis as well as reduction in late presentation and also better diagnostic tools for tuberculosis

Accessibility of Antiretroviral Therapy in Ghana: Convenience of Access

The convenience of accessing antiretroviral therapy (ART) is important for initial access to care and subsequent adherence to ART. We conducted a qualitative study of people living with HIV/AIDS (PLWHA) and ART healthcare providers in Ghana in 2005. The objective of this study was to explore the participants' perceived convenience of accessing ART by PLWHA in Ghana. The convenience of accessing ART was evaluated from the reported travel and waiting times to receive care; the availability; or otherwise; of special considerations; with respect to the waiting time to receive care; for those PLWHA who were in active employment in the formal sector; the frequency of clinic visits before and after initiating ART; and whether the PLWHA saw the same or different providers at each clinic visit (continuity of care). This qualitative study used in-depth interviews based on Yin's case-study research design to collect data from 20 PLWHA and 24 ART healthcare providers as study participants. . Reported travel time to receive ART services ranged from 2 to 12 h for 30 of the PLWHA.. Waiting time to receive care was from 4 to 9 h. . While known government workers; such as teachers; were attended to earlier in some of the centres; this was not a consistent practice in all the four ART centres studied. . The PLWHA corroborated the providers' description of the procedure for initiating and monitoring ART in Ghana. . PLWHA did not see the same provider every time; but they were assured that this did not compromise the continuity of their care. Our study suggests that convenience of accessing ART is important to both PLWHA and ART healthcare providers; but the participants alluded to other factors; including open provider-patient communication; which might explain the PLWHA's understanding of the constraints under which they were receiving care. The current nation-wide coverage of the ART programme in Ghana; however; calls for the replication of this study to identify possible perception changes over time that may need attention. Our study findings can inform interventions to promote access to ART; especially in Africa

Factors Influencing Condom Use Among Women in Ghana: an HIV/AIDS Perspective

Although in Ghana information on HIV infection and prevention; both in terms of quality and quantity; has increased considerably within the past few years; available literature indicates that behaviour change is yet to correspond with the amount of information and education provided. The objective of this study is to examine factors that influence condom use among women in Ghana in the context of HIV/AIDS prevalence. Data for this study are from the 2003 Ghana Demographic and Health Surveys (GDHS) and the study population (N=5 691) was analysed using logistic regression with the Health Belief Model (HBM) as an explanatory tool. The outcome variable for this study is condom use during last sexual intercourse. The HBM identifies perception of HIV/AIDS risks; awareness of its seriousness; knowledge about prevention; and confidence in condom use as predictors of safe sexual activity. Results show that the proportion of women reporting use of condoms remains tremendously low; in both the rural and urban areas. In the urban areas; only 15of women reported having sex with condom during their last intercourse; whereas in the rural areas the proportion is even lower (10). However; multivariate analyses based on the HBM components show that speaking with a partner about how to avoid AIDS (Odds Ratio = 1.63) and perceived benefits of using condoms (Odds Ratio = 1.54) are notable factors that predict condom use. Overall; the study points out that with the exception of perceived severity; the HBM can be applied to understand condom use among the study population. It will be important to emphasise all components of the HBM and empower women with condom negotiation skills

Seroepidemiology of Hepatitis-B Surface Antigenaemia in HIV Positive Patients

BACKGROUND: Hepatitis B virus (HBV) co-infection with HIV is a potential and significant cause of mortality and morbidity in HIV-positive patients. OBJECTIVE: This study was undertaken to determine the prevalence of hepatitis B surface antigen (HBsAg) among HIV positive patients and to identify the risk groups for HIV/ HBV co-infection among these patients. METHODS: The diagnosis of HIV infection was made using Determiner rapid screening kits and reactive samples were confirmed by enzyme linked immunosorbent assay (ELISA). The marker for HBV was HBsAg which was detected using an ELISA technique. RESULTS: HBsAg was repeatedly detected in 29 (28.4) of HIV-positive patients. Ninety-eight percent of the subjects were confirmed positive for HIV-1 and 1.9for HIV-2. There were 32(31.4) males and 70(68.6) females aged 20 to 75 years (mean +SD: 40+.11.7) .HIV/ HBV co-infection rate was highest in the age group 31-40 years.More males [12 (37.58)] than female subjects 17/70 (24.3) were HIV/HBV co-infected; (p 0.05). CONCLUSION: There is a high prevalence of HBsAg in HIV positive patients

Eye Complications of Acquired Immune Deficiency Syndrome (AIDS) Part 1. Ocular Surface and Anterior Segment Manifestations

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Feeding Infants whose Mothers are HIV-Positive

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A clinical and epidemiologic update on the interaction between tuberculosis and human immunodeficiency virus infection in adults

Background : Tuberculosis (TB) is an important cause of mortality and morbidity in human immunodeficiency virus (HIV) infection in Africa. The interaction between TB and HIV infections is reviewed. Methods : Literature on TB; HIV and their co-infection; especially in sub-Saharan Africa; including Nigeria; is reviewed. Results : Burden of TB is fueled by the HIV epidemic; and clinical presentation of TB may be atypical with co-infection. Recommendations on drugs and timing of antiretroviral therapy (ART) initiation are discussed. Use of cotrimoxazole prophylaxis (CPT) in co-infected patients reduces morbidity and mortality; while the principles of TB prevention in HIV infection can be summarized with the three I's: intensive TB case finding and surveillance; isoniazid preventive therapy (IPT) and infection-control measures; to these can be added a fourth 'I;' viz.; instituting ART. Clinical complications like drug resistance; toxicity and drug interactions; and immune reconstitution inflammatory syndrome (IRIS) with CPT; IPT and ART are highlighted. Emergence of drug-resistant- and nosocomial- TB in HIV infection poses serious challenges and potential consequences in Africa; and appropriate measures are recommended. Conclusions : Many barriers exist for optimizing the care of the two diseases; but the aim should be strengthening capacities; collaborations; linkages and eventually integrating the services. Interventions for TB prevention in HIV infection should be widely implemented

Opportunistic and other Intestinal Parasitic Infections in Aids Patients; HIV Seropositive healthy carriers and HIV seronegative Individuals in SouthWest Ethiopia

Background: Human Immunodeficiency Virus (HIV) infection leads to acquired immunodeficiency syndrome (AIDS) and major causes of morbidity and mortality of such patients are opportunistic infections caused by viral; bacterial; fungal and parasitic pathogens. Objectives: To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among AIDS patients and HIV positive carrier individuals Method: Cross-sectional study was conducted among AIDS patients; HIV positive healthy carriers and HIV negative individuals in Jimma University Hospital; Mother Theresa Missionary Charity Centre; Medan Acts Projects and Mekdim HIV positive persons and AIDS orphans' national association from January to May; 2004. Convenient sampling technique was employed to identify the study subjects and hence a total of 160 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of the patients. Stool samples were examined by direct saline; iodine wet mount; formol-ether sedimentation concentration; oocyst concentration and modified Ziehl-Neelsen staining technique. Results: Out of 160 persons enrolled in this study 100(62.5) (i.e. 65 male and 35 female) were infected with one or more intestinal parasites. The highest rate 36(69.2) of intestinal parasites were observed among HIV/AIDS patients; followed by HIV positive healthy carriers 35 (61.4) of and HIV negative individuals (29(56.9). Isospora belli 2(3.9); Cryptosporidum parvum 8(15.4); Strongyloides stercoralis 6(11.5) and Blastocystis 2(3.9) were found only in HIV/AIDS groups Conclusion: I. belli; C. parvum; S. stercoralis and Blastocystis are the major opportunistic intestinal parasites observed in HIV/AIDS patients. Therefore; early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients with diarrhoea

Treatment and Outcome of Hospitalised; Very Young; HIV-Infected Children

Objective: To describe the disease severity; clinical course and outcome of hospitalised HIV-infected children aged 6 months. Methods: A retrospective case review was completed at Red Cross Children's Hospital during mid-2006. The perinatal management; disease severity; and hospital outcome were analysed. In a sub-analysis; the disease profile and outcome of admitted children aged less than and greater than 6 months were compared over the latter 3 months of the study. Results: 75/121(43.86) of all HIV-infected children admitted over the study period were 6months were more likely to be receiving cotrimoxazole prophylaxis (65.4vs. 31.1; p=0.0008) and HAART (42.3vs. 6.7; p=0.00007) at the time of admission. Of those not on HAART; 27/30(90) had WHO stage 3 or 4 disease. In patient fatality in this group was 13.5Conclusions: Young children constitute a sizable proportion of the inpatient paediatric HIV workload. Comprehensive PMTCT interventions and earlier introduction of HAART may reduce morbidity; hospitalisation rates and mortality

Prevalence des infections opportunistes digestives parasitaires a Kinshasa (Republique Democratique du Congo). Resultats d'une enquete preliminaire chez 50 patients au stade SIDA

En Republique Democratique du Congo (RDC); comme dans de nombreux pays africains; le sida et son cortege d'infections opportunistes sont une cause majeure de morbidite et de mortalite. A Kinshasa; on estime entre 4 et 5le taux de prevalence de sujets infectes par le VIH; soit plus de 200 000 personnes (chiffres du Programme National de Lutte contre le Sida; PNLS 2005). A ce jour; faute de personnels formes et de moyens diagnostiques adaptes; aucune enquete n'a encore ete menee sur la prevalence des parasites opportunistes digestifs dans la population des patients infectes par leVIH; prealable indispensable a la mise en place d'une politique de soin adaptee. Une enquete preliminaire a ete realisee a Paris sur 50 echantillons de selles de 50 patients malades du sida; hospitalises dans 3 hopitaux de references de Kinshasa. Onze patients (22) avaient une symptomatologie digestive avec un syndrome diarrheique. La realisation des examens specialises a mis en evidence 2 cas d'infection digestive par des parasitoses opportunistes (4); une a Cryptosporidium sp. et une a Enterocytozoon bieneusi; premier cas decrit dans la litterature en RDC

Syndrome de nephropathie lie au VIH: une observation a Dakar

Cette etude concerne un patient de race noire age de 40 ans en consultation pour un syndrome oedemateux de type renal; et des signes d'immunodepression.Les resultats obtenus a l'issue de ce travail ont permis d'insister sur la necessite de penser a la nephropathie liee au VIH chez tout patient de race noire presentant un syndrome nephrotique impur rapidement progressif. Les auteurs souhaitent realiser des etudes prospectives pour determiner la place de la NVIH dans les aspects cliniques du VIH au Senegal

Etude epidemiologique; clinique; biologique et radiologique des infections opportunistes a localisation neuromeningee chez l'enfant VIH positif en milieu hospitalier : a propos de 6 cas observes au CHu de Yopougon

Nous avons effectue une etude retrospective portant sur 6 (six) dossiers de malades hospitalises pour infection opportuniste du SNC diagnostiquee dans le service de Pediatrie Medicale du CHU de Yopougon de juin 1995 a juin 2002.*Sur le plan epidemiologique; les enfants etaient ages de 3 a 15 ans. La tranche d'age la plus touchee etait celle comprise entre 10 et 15 ans (3/6 soit 50pour cent) et 2/6 soit 33pour cent de nos patients avaient moins de 5 ans.La transmission materno-foetale etait le mode de contamination le plus frequemment rencontre chez nos patients. L'association des signes majeurs et les signes mineurs de Bangui ont ete retrouves dans les antecedents de tous nos patients.* Sur le plan clinique; les signes cliniques de l'infection VIH etaient retrouves chez tous nos patients avec une predominance de la fievre au long cours; de l'amaigrissement et la candidose oropharyngee representes chez 83pour cent (5/6) de nos patients suivis des signes d'infection pulmonaire (4/6 soit 66pour cent) et des lymphadenopathies (2/6 soit 33pour cent).Les signes neuromeninges tels le coma; le deficit moteur; les convulsions etaient les signes les plus frequemment rencontres (3/6 soit 50pour cent de nos patients); suivis de la raideur de la nuque; la baisse de l'acuite visuelle et le syndrome d'hypertension intracranienne representes a 33pour cent.Les difficultes diagnostiques etaient liees a la non specificite des signes cliniques.* Sur le plan biologique; 5/6 soit 83pour cent de nos patients avaient comme type de virus le VIH1 (serotype predominant en Cote d'Ivoire) et 16 pour cent avaient le VIH1 et 2Chez 2/6 (33pour cent) de nos patients qui ont pu avoir un dosage des CD4 et de la charge virale; le deficit immunitaire etait severe (6pour cent et 10;4pour cent). Tandis que la charge virale etait elevee (1.075.217 copies/ml et 279.932 copies/ml). Ce deficit immunitaire severe a favorise l'apparition des infections opportunistes du SNC.*Sur le plan radiologique; les images tomodensitometriques revelaient des hypodensites chez la majorite de nos patients (4/6 soit 66pour cent) suivies de l'atrophie cortico-sous-corticale (3/6 soit 50pour cent de nos patients) et enfin des processus expansif (meningiome et tuberculome) chez 2/6 soit 33pour cent des patients. Les caracteres non specifiques de ces manifestations sont a l'origine des difficultes de diagnostic de ces infections opportunistes.* Sur le plan des etiologies; les differentes investigations ont permis de retenir trois groupes etiologiques: la toxoplasmose etait l'etiologie predominante (3/6 soit 50pour cent de nos patients); la tuberculose (3/6 soit 50pour cent des patients); suivies de la cryptococcose neuromeningee (1/6 soit 16pour cent des patients).*L'evolution chez tous nos patients a ete fatale a plus ou moins long terme