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Central nervous system involvement of children with HIV infection
1Department of Paediatric Neurology, Goethe Universität, Frankfurt, Germany.
Insights
Neurological symptoms in children with human immunodeficiency virus (HIV) infection were studied. Early treatment with azidothymidine (AZT) and intravenous immunoglobulin therapy (IVIG) showed promise in preventing neurological decline.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroimmunology
Background:
- Human immunodeficiency virus (HIV) infection can lead to significant neurological complications in children, collectively known as HIV encephalopathy.
- Understanding the spectrum of neurological manifestations and the impact of early interventions is crucial for managing pediatric HIV.
Purpose of the Study:
- To describe the neurological findings in a cohort of HIV-seropositive children.
- To evaluate the potential benefits of azidothymidine (AZT) and intravenous immunoglobulin therapy (IVIG) in preventing or mitigating neurological deterioration.
Main Methods:
- Retrospective analysis of neurological findings in 41 HIV-seropositive children.
- Categorization of children based on symptoms, immunodeficiency status, and age.
- Observation of neurological outcomes in children receiving AZT and/or IVIG.
Main Results:
- Neurological symptoms indicative of HIV encephalopathy included acquired microcephaly, developmental regression, motor deterioration, developmental delay, mental retardation, cerebellar signs, and behavioral changes.
- Three children with progressive encephalopathy showed improvement following azidothymidine (AZT) treatment.
- No mental deterioration was observed in eight children receiving prophylactic intravenous immunoglobulin therapy (IVIG) and seven receiving both IVIG and AZT.
Conclusions:
- Neurological complications are a significant concern in pediatric HIV infection.
- Early therapeutic interventions, including AZT and IVIG, may play a role in preventing or improving neurological outcomes in HIV-infected children.
Abstract:
The neurological findings in 41 HIV-seropositive children are described. 23 children were symptomatic, eight seropositive but without symptoms and 10 seropositive children less than 15 months of age had no other evidence of immunodeficiency. Acquired microcephaly, developmental regression and progressive motor deterioration indicated HIV encephalopathy, as did developmental delay, mental retardation, cerebellar symptoms and behavioural changes. Three children with progressive encephalopathy improved after treatment with azidothymidine (AZT). In eight children treated with prophylactic intravenous immunoglobulin therapy (IVIG) and seven treated with both IVIG and AZT, no mental deterioration has been observed since the beginning of therapy. One child with advanced encephalopathy and severe pyramidal tract involvement did not improve.