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Neurologic disorders in HIV-positive orphans: 10 years of follow up

Eva Grey1, Maria Hardy1, Veronika Sladeckova1

  • 1St. Maximilian Kolbe Clinic, SEU Tropical program, House of Family, Phnom Penh, Cambodia.

Neuro Endocrinology Letters
|September 10, 2013
PubMed

Insights

Neurologic disorders in children on highly active antiretroviral therapy (HAART) are uncommon. While drug toxicities were rare, neurotropic viral co-infections occurred but were successfully treated with antivirals.

Area of Science:

  • Pediatric infectious diseases
  • Neurovirology
  • Global health

Background:

  • Neuropsychic manifestations of Acquired Immunodeficiency Syndrome (AIDS) remain a concern, particularly in developing nations.
  • Highly active antiretroviral therapy (HAART) has transformed HIV management, but potential neurological side effects require ongoing evaluation in pediatric populations.

Purpose of the Study:

  • To describe psychological, behavioral, and neurological disorders in HIV-infected children receiving HAART in Cambodia.
  • To assess the impact of HIV-related disorders and drug toxicities on neurological health in this cohort.

Main Methods:

  • A prospective analysis of 137 HIV-positive children (ages 2-19) treated with HAART from 2003-2012.
  • Data collected included opportunistic infections, co-infections, renal and hematologic parameters, and treatment regimens (HAART, anti-tuberculosis, antibiotics).

Main Results:

  • Drug-related neuritis occurred in less than 1% of children, primarily associated with stavudine and anti-tuberculosis agents.
  • Neurotropic viral co-infections, including Cytomegalovirus (CMV) retinitis and Herpes Zoster Virus (HZV) infections, were more frequent.
  • All viral co-infections responded well to antiviral therapies such as ganciclovir, vanciclovir, or acyclovir.

Conclusions:

  • Neurological disorders are less frequent in children undergoing HAART compared to adults.
  • Antiretroviral and anti-tuberculosis drugs demonstrated a favorable safety profile in pediatric patients.
  • Prompt antiviral treatment effectively managed neurotropic viral co-infections in HIV-infected children.
Abstract

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