Early Immunological Predictors of Neurodevelopmental Outcomes in HIV‐Infected Children

Immune activation and paediatric HIV-1 disease outcome

“…Viral set point is only established after several years of infection as opposed to a few weeks in adult infection (25, 26) and there is a substantial overlap in viral loads between children who progress and those who do not progress to disease (24, 27). Hence, the relationship between viral load and immune activation is weaker in children than in adults (17, 19, 21, 28, 29). …”

Early Immune Activation Predicts Central Nervous System Disease in HIV‐Infected Infants: Implications for Early Treatment

“…The most significant finding of the study by Mekmullica et al [8] was the strong association between performance at SUNY Health Science Center at Brooklyn -Medical Research Library on March 21, 2015 http://cid.oxfordjournals.org/ Downloaded from on Bayley tests, especially PDI but also MDI, and р5% versus 15% CD8 + HLA-DR + T cells. On the other hand, there were no statistically significant differences noted in relation to death and encephalopathy.…”

“…Given the catastrophic potential complications related to CNS disease in infants and children, the study by Mekmullica et al [8] in this issue of Clinical Infectious Diseases has implications not only for early identification and treatment of infants at risk for CNS disease but also for our understanding of the basic pathogenesis of early encephalopathy. In the study, the authors evaluated neurobehavioral data, using the Bayley scales of infant development, performed from birth through age 30 months among 98 infants who also had CD8 activation data from the first 2 months of life obtained as part of the Women and Infants Transmission Study in 1989-1994.…”

“…CD8 + DR + 38 Ϫ T cells are associated with long-term nonprogression and stable CD4 T cells [20,21]. Furthermore, although Mekmullica et al [8] examined the predictive value of CD8 + CD38 + T cells, the marker that is generally associated with poorer clinical outcome and CNS disease [21,22], there was no association noted with CNS disease, at least at the level of activation that was evaluated. The lack of association between psychomotor or mental outcome and percentage of CD8 + CD38 + T cells may be merely related to methodology and not the actual outcome.…”

The Use of Second-Generation Antipsychotics and the Changes in Physical Growth in Children and Adolescents with Perinatally Acquired HIV

“…[3][4][5][6] Children and adolescents with perinatally acquired HIV-1 infection face multiple risks to their mental health, possibly starting with in utero exposure to the antiretroviral (ARV) medications taken during pregnancy. 7,8 In addition, there is the ongoing exposure of the developing brain to the slow but progressive immune dysregulation that characterizes HIV infection 9,10 and the required ARV medications, some of which appear to have significant central nervous system (CNS)-related side effects (e.g., efavirenz). 11 The risk of mental health problems continues through childhood due to potential prior or current parental mental illness and substance abuse, as well as environmental factors that frequently co-occur within the context of HIV infection, such as poverty, inadequate social support, and unstable housing.…”