Neurologic and neurodevelopmental manifestations of pediatric HIV/AIDS: a global perspective

Area of Science:

• Neuroscience
• Infectious Diseases
• Pediatrics

Background:

• Neurodevelopmental abnormalities are a known complication of pediatric HIV-1 infection.
• Progressive HIV-1 encephalopathy (PHE) affected a significant percentage of children before widespread antiretroviral therapy (ART).
• ART can prevent and partially reverse PHE, but residual neurological issues persist.

Purpose of the Study:

• To review the literature on pediatric neuroAIDS.
• To identify gaps in understanding the mechanisms of pediatric HIV-1 neuropathogenesis.
• To explore factors associated with neurodevelopmental abnormalities in perinatally infected children, particularly in resource-limited settings.

Main Methods:

• Literature review of pediatric neuroAIDS studies.
• Analysis of existing data on neurological manifestations in HIV-1 infected children.
• Examination of the central nervous system (CNS) as a distinct viral reservoir.

Main Results:

• HIV-1 enters the CNS early and persists, forming a unique viral reservoir.
• Neurotropic HIV-1 may develop distinct genetic characteristics within the CNS.
• Significant knowledge gaps exist regarding pediatric neuroAIDS, especially in developing countries with limited ART access.

Conclusions:

• Despite ART, neurodevelopmental abnormalities remain a concern in pediatric HIV-1 infection.
• Understanding the CNS as a viral reservoir is crucial for pediatric neuroAIDS research.
• Further investigation is urgently needed, particularly in regions where ART access is limited, to address pediatric neuroAIDS effectively.