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Neurologic signs in young children with human immunodeficiency virus infection. The European Collaborative Study
Insights
Neurologic problems were less common in HIV-infected children than previously reported. Early detection and intervention are crucial for managing neurodevelopmental issues in children affected by HIV.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Human immunodeficiency virus (HIV) infection can impact neurologic and neurodevelopmental outcomes in children.
- Previous studies have reported a high prevalence of neurologic issues in HIV-infected children.
- Understanding the spectrum of neurologic problems in this population is essential for effective management.
Purpose of the Study:
- To investigate the prevalence and nature of neurologic and neurodevelopmental problems in a cohort of HIV-infected children.
- To compare the neurologic outcomes of HIV-infected children with those of uninfected children born to HIV-positive mothers.
- To identify factors associated with neurologic manifestations in both infected and uninfected children.
Main Methods:
- A prospective cohort study followed 39 HIV-infected children and 164 antibody-negative children born to HIV-positive women from birth up to 4 years.
- Children were monitored for the development of neurologic and neurodevelopmental problems.
- Neurologic manifestations were assessed in relation to HIV status, disease progression (AIDS/ARC), and other factors like drug withdrawal and prematurity.
Main Results:
- Serious neurologic manifestations were observed in 31% of HIV-infected children who developed acquired immunodeficiency syndrome/acquired immunodeficiency syndrome-related complex (AIDS/ARC).
- In contrast, 0% of asymptomatic or less severely affected HIV-infected children and 1% of uninfected children exhibited significant neurologic signs.
- Neurologic signs in the uninfected group were linked to drug withdrawal at birth and prematurity.
Conclusions:
- The prevalence of serious neurologic problems in this cohort of HIV-infected children appears lower than reported in some previous studies.
- HIV-infected children progressing to AIDS/ARC are at higher risk for neurologic complications.
- Neurologic signs in uninfected children born to HIV-positive mothers can be attributed to factors other than HIV exposure, such as drug withdrawal and prematurity.
Abstract:
Neurologic and neurodevelopmental problems were investigated in a cohort of 39 human immunodeficiency virus (HIV)-infected children and 164 antibody-negative children born to HIV-positive women. All children were followed from birth for between 1 month and 4 years. Serious neurologic manifestations were present in 5 of 16 children (31%) who developed acquired immunodeficiency syndrome/acquired immunodeficiency syndrome-related complex, although in 2 the neurologic signs were probably not related to HIV. This can be compared with a prevalence of 0 of 23 in children who remained asymptomatic or who had less severe HIV-related symptoms or signs and 2 of 164 (1%) in uninfected children. Neurologic signs in the uninfected group were associated with the presence of drug withdrawal at birth and prematurity. These findings contrast with reports of a high prevalence of neurologic findings in most studies of HIV-infected children.