Progressive encephalopathy in children with acquired immue deficiency syndrome

Epstien, Leon G.; Sharer, Leroy R.; Joshi, Vijay V.; Fojas, Myrna M.; Koenigsberger, M. Richard; Oleske, James M.

doi:10.1002/ana.410170512

Cited by 251 publications

(72 citation statements)

References 18 publications

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“…Pollack et al (1996) reported that: linear growth failure precedes cognitive and motor delay; growth failure is positively correlated with cognitive and motor delay; and onset of neurodevelopmental delay is earlier in infants with growth delay than in those without. Acquired microcephaly, indicating impaired growth of the brain, was reported in early studies of paediatric HIV (Belman, et al, 1988;Belman, et al, 1985;Epstein, et al, 1985;Ultmann, et al,1985).…”

Section: At Assessmentmentioning

confidence: 95%

“…This was the first official report on paediatric HIV in the US. Epstein, et al, 1985;Ultmann, et al,1985).…”

Section: Pre-antiretroviral Eramentioning

confidence: 99%

“…The clinical studies in the 1980s were also the first to document the neurological sequelae seen in children with HIV infection, identify a correlation between clinical disease progression with pathological findings (Belman, et al, 1988;Belman, et al, 1985;Epstein, et al, 1985;Ultmann, et al, 1985) and suggest HIV infection as the primary cause of encephalopathy (Epstein, et al, 1986). Attempts were made during this time to objectify the medical observations by employing the first edition of the BSID, the Denver Developmental Screening Test, First Edition and the Stanford Binet Ultmann, et al, 1985).…”

Section: Pre-antiretroviral Eramentioning

confidence: 99%

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Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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The aim of this cross-sectional study was to determine the difference in development (cognition; receptive and expressive language; and fine and gross motor) of Human Immunodeficiency Virus (HIV) -exposed infected (HEI) infants with the development of HIV-exposed but uninfected (HEU) infants using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sixty infants were enrolled in the study; 32 (53.33%) HEU infants and 28 (46.67%) HEI infants. The two groups were well-matched for infant demographics, anthropometry at birth, maternal demographics, as well as socioeconomic status. Statistically significant differences were found in anthropometry and development between the HEI and HEU group. The HEI infants had malnutrition, were stunted and had smaller head circumferences than HEU infants. The BSID-III showed that the mean developmental delay for the HEI group was approximately two months below their mean chronological age for all scales (cognitive; receptive and expressive communication; and, fine and gross motor age).The HEI group showed that 64.29% had cognitive delay, 60.71% had language delay and 53.57% had motor delay, all of which was significantly different from the development of the HEU group for all domains (p<0.001). In addition to using the BSID-III, the majority of mothers were able to correctly indicate whether their child was developing at the same, or at a slower rate of development than children of the same age. This study demonstrates that infants who are HIV-exposed and infected are at risk of developmental delay.

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Section: At Assessmentmentioning

confidence: 95%

“…This was the first official report on paediatric HIV in the US. Epstein, et al, 1985;Ultmann, et al,1985).…”

Section: Pre-antiretroviral Eramentioning

confidence: 99%

Section: Pre-antiretroviral Eramentioning

confidence: 99%

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Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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“…A great deal of research has been done on the involvement of the CNS in the course of AIDS [6,7]. Anatomo-pathological findings demonstrating cortical and subcortical atrophy, encephalitis, neuronal apoptosis, diffuse leukoencephalopathy and calcification of the basal ganglia are evidence of the consequences of HIV infection in the CNS.…”

mentioning

confidence: 99%

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

Tahan¹,

Bruck²,

Burger³

et al. 2006

Braz J Infect Dis

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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.

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“…1 Although pediatric acquired immunodeficiency syndrome (AIDS) cases have been reported since 1983 2,3 and, soon after, many authors started to highlight the central nervous system involvement in the course of the disease, 4,5 little is known concerning these patients' peripheral nervous system status. 6,7 Peripheral neuropathy is common in HIV-infected adults, 8 -10 either related to the disease or to its treatment.…”

mentioning

confidence: 99%

Distal Sensory Polyneuropathy in a Cohort of HIV-Infected Children Over Five Years of Age

2000

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ABSTRACT. Background. Peripheral neuropathy in children with human immunodeficiency virus (HIV) infection has not been systematically studied.Objectives. To describe the symptoms and signs of peripheral neuropathy in HIV-infected children and to determine their frequency.Methods. A cross-sectional study was conducted on a convenience sample from a cohort of children older than 5 years of age at the pediatric HIV outpatient clinic of the Federal University of Rio de Janeiro. Those patients were interviewed and examined systematically for peripheral nerve symptoms and signs.Results. A total of 39 patients were clinically evaluated. Their ages ranged from 5 to 14 years, and 13 patients (34%) had symptoms and signs of peripheral nerve involvement. Distal paresthesia and/or pain plus diminished ankle jerks and/or diminished vibration sense were the most common clinical findings. Symptoms were chronic and fluctuating, and pain was, in general, not severe. Nerve conduction studies primarily revealed axonal changes.Conclusions. Peripheral neuropathy occurs in one third of HIV-infected children, and, in general, has less severe features than the distal sensory polyneuropathy described in adults. Pediatrics 2000;106(3). URL: http:// www.pediatrics.org/cgi/content/full/106/3/e35; peripheral neuropathy, human immunodeficiency virus, children.ABBREVIATIONS. HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome; CDC, Centers for Disease Control and Prevention; ddI, dideoxyinosine. W orldwide, children are still becoming infected with the human immunodeficiency virus (HIV). 1 Although pediatric acquired immunodeficiency syndrome (AIDS) cases have been reported since 1983 2,3 and, soon after, many authors started to highlight the central nervous system involvement in the course of the disease, 4,5 little is known concerning these patients' peripheral nervous system status. 6,7 Peripheral neuropathy is common in HIV-infected adults, 8 -10 either related to the disease or to its treatment. It may present as inflammatory demyelinating polyneuropathy, mononeuropathy, mononeuritis multiplex, polyradiculopathy, subclinical neuropathy, or, more frequently, as distal sensory polyneuropathy.In 1991, Raphael et al 6 reported the case of a 5-year-old boy with AIDS who had developed an inflammatory demyelinating polyneuropathy. In 1997, Floeter et al 7 described the electrophysiologic data of 50 HIV-infected patients under 18 years of age referred for evaluation of suspected neuropathy. A variety of abnormalities were described, including a probable distal sensory axonal neuropathy in 7 of the oldest children. Although biased by referral, this study suggested that at least some children eventually do develop peripheral neuropathy.The epidemiology of HIV infection is evolving. More children are becoming infected, and attributable to better management strategies, they are surviving longer. The paucity of reports on peripheral neuropathy in HIV-infected children may reflect agerelated differences in regenerative capacit...

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Progressive encephalopathy in children with acquired immue deficiency syndrome

Cited by 251 publications

References 18 publications

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

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

Distal Sensory Polyneuropathy in a Cohort of HIV-Infected Children Over Five Years of Age

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