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Clinical features and risk factors for HIV encephalopathy in children

M Z A Hamid1, N A Aziz, Z Syed Zulkifli

  • 1Department of Pediatrics, Faculty of Medicine and Health, Universiti Putra Malaysia, Serdang, Selangor. zaini@medic.upm.edu.my

The Southeast Asian Journal of Tropical Medicine and Public Health
|June 21, 2008
PubMed

Insights

Progressive encephalopathy (PE) affected 18.2% of children with HIV in Malaysia. Lower CD4 counts and percentages were linked to PE development in this pediatric cohort.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • Human Immunodeficiency Virus (HIV) infection can lead to neurological complications in children.
  • Progressive encephalopathy (PE) is a serious neurodevelopmental disorder associated with HIV/AIDS.
  • Understanding the incidence and clinical features of PE in pediatric HIV cohorts is crucial for early diagnosis and management.

Purpose of the Study:

  • To determine the incidence of progressive encephalopathy (PE) in children with HIV.
  • To identify clinical manifestations and associated factors of PE in this cohort.
  • To assess the relationship between immunological markers (CD4 counts, CD4 percentages) and PE.

Main Methods:

  • Prospective cohort study of 55 children with HIV over 24 months.
  • Regular neurological, neurobehavioral, and immunological assessments (CD4, viral load, IQ).
  • Diagnosis of PE based on established criteria from the Consensus of Pediatric Neurology/Psychology Working Group.

Main Results:

  • The incidence of PE was 18.2% (10 out of 55 children) in 2002.
  • Common clinical signs included hepatosplenomegaly, lymphadenopathy, and abnormal deep tendon reflexes.
  • Five patients exhibited impaired brain growth; lower CD4 counts and percentages were significantly associated with PE.

Conclusions:

  • Progressive encephalopathy is a significant concern in pediatric HIV infection.
  • Immunological status, particularly CD4 cell counts and percentages, is strongly associated with the development of PE.
  • Regular neurological monitoring and assessment of immunological markers are essential for managing HIV-infected children at risk for PE.

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