Neurological profile and neurodevelopment of 88 children infected with HIV and 84 seroreverter children followed from 1995 to 2002

Abstract

This study evaluated the degree of neurological compromise in HIV-infected children accompanied by the outpatient clinic of infectious diseases and pediatric neurology of the Clinical Hospital of the Federal University of Paraná (UFPR) starting in 1995. Long-term progressive prospective and cross sectional study of 88 children infected by HIV and 84 seroreverter children, using data from general neurological examinations, neuroimaging procedures (brain CT scan) and neurodevelopmental tests (CAT/CLAMS and DENVER I and II). Neurological and neurodevelopmental alterations were found in 82% of the HIV-infected patients and in 36% of the HIV-seroreverter group (P <0.01). In the CAT/ CLAMS test, the development quotient (DQ) of the HIV-infected group was significantly lower than that of the HIV-seroreverter group. CAT/CLAMS scores lower than 70 (mental deficiency) were found in 31% of the HIV-infected patients during the first year of life and in only 1% of the patients of the HIV-seroreverter group, demonstrating the validity of this screening test for precocious detection of alterations in the neurodevelopment of infected patients. The same occurred with the Denver I and II tests, as the HIV-infected group failed more frequently than the HIV-seroreverter group. Nine HIVinfected children presented altered brain CT scans; calcification of basal ganglia was the main finding (five cases). Encephalopathy due to HIV causes early arrest of neurodevelopment, which can be detected with screening tests during the first year of life.

HIV‐1 alters neural and glial progenitor cell dynamics in the central nervous system: Coordinated response to opiates during maturation

“…This is not surprising, since much of CNS development occurs after birth, and the immature brains of children or adolescents exposed to HIV are highly vulnerable to pathologic agents. CNS disease in pediatric HIV patients manifested as static or progressive encephalopathy, with classic symptoms including delay or loss of major motor and mental milestones, and atrophy of cortical/subcortical regions and other abnormalities on CT scans (Drotar et al 1997; Epstein et al 1988; Schwartz and Major 2006; Tahan et al 2006; Ultmann et al 1985; Van Rie et al 2007). In developed countries, rates of HIV-1 vertical transmission have been reduced to 1–2%, from 40% in 1995 (Buchholz et al 2010; Van Dyke 2011).…”

Neurologic and Neurobehavioral Sequelae in Children With Human Immunodeficiency Virus (HIV-1) Infection

“…3 The prevalence of these specific neurologic complications in children with HIV-1 is limited to a few studies (Table 1). [4][5][6][7][8][9][10][11][12][13] A systematic review of 6 studies in Sub-Saharan Africa reported severe motor impairment and moderate cognitive impairment at 18 months of age in HIV-1 infected children. 14 A study from the Democratic Republic of Congo showed that environmental factors contribute to developmental dysfunction.…”

Neurology and the Global HIV Epidemic

“…36,50,[63][64][65] In addition, there is a growing body of literature exploring the development of HIV-infected children. Infants and children with HIV in resource-limited settings generally demonstrate developmental deficits as compared with their HIVuninfected peers, [66][67][68] though one small Thai study did not demonstrate significant impairment. 69 Peripheral neuropathy has also been an important topic of study, as the prevalence of distal symmetric peripheral neuropathy in HIV-infected persons ranges from 20 to 60% in resource limited settings.…”