[Neuropsychological impairment in human immunodeficiency virus-positive children]

From human immunodeficiency virus (HIV)/AIDS epidemic onset in 1981 through 2003, 580,000 infants, children and adolescents died worldwide. Currently, between 2.1 and 2.9 million are estimated to live with HIV/AIDS. Here we review the main features of HIV/AIDS in infants, children and adolescents from a neuropsychological stance. Also, we review current neuropsychological tests for assessment of HIV/AIDS-associated neuropsychological impairment in infants, children and adolescents.

Most HIV-positive infants and children will die before adolescence. These children present both neurological and neuropsychological derangements with a variety of cognitive and motor deficits and important differences in their course. The main neurological condition related to HIV infection in childhood is HIV-associated progressive encephalopathy, which may be the initial presenting condition for AIDS in 18% of cases, affecting 30-60% of seropositive infants, children and adolescents at any time point of their disease. HIV-associated progressive encephalopathy causes neuropsychological deficits involving a wide variety of domains, such as speed and language, memory, learning, information processing and motor functioning. They may affect negatively children's normal development and school achievement.

It is crucial to determine how infection affects HIV-positive children and adolescents' development and to establish which interventions are more efficient to help them to be successful at school. Also, it is necessary to determine confounding variable role in HIV-positive infants, children and adolescents' cognitive development to determine direct and indirect HIV-infection effects on neuropsychological development.