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Oral Combinational Antiretroviral Treatment in HIV-1 Infected Humanized Mice
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Neurocognitive functioning in pediatric human immunodeficiency virus infection: effects of combined therapy

Manisha C Shanbhag1, Richard M Rutstein, Theoklis Zaoutis

  • 1Division of General Pediatrics, Childrens Hospital of Philadelphia, Philadelphia, PA 19103, USA. shanbhag@email.chop.edu

Archives of Pediatrics & Adolescent Medicine
|July 6, 2005
PubMed

Insights

Combination antiretroviral therapy has improved neurocognitive outcomes in children with perinatally acquired human immunodeficiency virus (HIV) infection. Fewer children now experience progressive encephalopathy, and neurocognitive function is preserved over time.

Area of Science:

  • Pediatric infectious diseases
  • Neurovirology
  • Clinical immunology

Background:

  • Perinatally acquired human immunodeficiency virus (HIV) infection can impact neurocognitive development.
  • Combination antiretroviral therapy (cART) has transformed HIV management.
  • Understanding the long-term neurocognitive effects of cART in this population is crucial.

Purpose of the Study:

  • To evaluate the impact of cART on neurocognitive outcomes in perinatally HIV-infected children.
  • To identify if CD4 percentage and plasma HIV-1 RNA levels predict future neurocognitive function.

Main Methods:

  • Retrospective cohort study at an urban HIV-dedicated care center.
  • Included 146 perinatally HIV-infected children with at least one neurocognitive evaluation.
  • Assessed neurocognitive standard testing scores and encephalopathy diagnoses.

Main Results:

  • Prevalence of progressive encephalopathy decreased significantly after 1996 (29.6% to 12.1%).
  • Overall encephalopathy prevalence dropped from 40.7% to 18.2% in the same periods.
  • Neurocognitive scores remained stable in healthy children and improved in those treated after 1996.

Conclusions:

  • Fewer children diagnosed with progressive encephalopathy since 1996.
  • Neurocognitive function is preserved in children deemed healthy at baseline.
  • Viral load and CD4 percentage show marginal predictive value for neurocognitive changes.
Abstract

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