Seizures are among the most common neurologic events that occur among people with HIV, but there is little epidemiologic data available to guide clinical decision-making regarding whether or when to initiate long term antiepileptic drug (AED) treatment for HIV+ individuals who experience a first seizure. In Zambia, where epilepsy and AIDS prevalence rates are both high and only enzyme-inducing AEDs are routinely available, the risk of interactions between AEDs and antiretroviral medications (ARVs) is especially concerning. This Zambian-based prospective cohort study of HIV+ adults who have experienced new onset seizure will provide important insights into seizure recurrence rates and risk factors for future seizures in people with HIV/AIDS. Knowledge gained from this work will assist clinicians in determining when/whether to initiate chronic treatment for seizures. This project will also expand the capacity for epidemiologic studies of neurologic disorders among people with HIV/AIDS in Zambia and lay the groundwork for the conduct of future research aimed at determining whether the co-usage of enzyme-inducing AEDs and ARVs predispose patients to ARV drug failure and potentially increase the risk of drug resistant HIV.

Public Health Relevance

As antiretroviral treatments become broadly available in Africa, HIV is evolving from a fatal infection into a chronic condition. Caring for people with HIV/AIDS who also suffer from other chronic health conditions, such as epilepsy, is challenging because clinicians do not have sufficient knowledge to know what treatments are best when these disorders co-occur. This prospective study of HIV+ Zambian adults will provide us with important insights into when chronic treatment for seizure prevention is needed and develop the research expertise and foundational knowledge to determine, in future studies, whether combining antiretroviral medications with the older generation epilepsy medications still used in most resource poor settings increases the risk of antiretroviral drug failure.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NS073509-02
Application #
8217127
Study Section
Special Emphasis Panel (ZRG1-ICP2-B (51))
Program Officer
Fureman, Brandy E
Project Start
2011-02-01
Project End
2014-01-31
Budget Start
2012-02-01
Budget End
2014-01-31
Support Year
2
Fiscal Year
2012
Total Cost
$118,992
Indirect Cost
$14,240
Name
Michigan State University
Department
Neurology
Type
Schools of Osteopathic Medicine
DUNS #
193247145
City
East Lansing
State
MI
Country
United States
Zip Code
48824
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Siddiqi, Omar K; Atadzhanov, Masharip (2013) Neurological letter from Zambia. Pract Neurol 13:281-5
Siddiqi, Omar K; Koralnik, Igor J; Atadzhanov, Masharip et al. (2013) Emerging subspecialties in neurology: global health. Neurology 80:e78-80