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HIV encephalopathy with bilateral lower limb spasticity: gross motor function and antiretroviral therapy

Theresa N Mann1,2, Barbara Laughton3, Kirsten A Donald4

  • 1Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.

Developmental Medicine and Child Neurology
|January 24, 2017
PubMed

Insights

Gross motor function in children with human immunodeficiency virus encephalopathy (HIVE) and bilateral lower limb (BLL) spasticity varies widely. Early antiretroviral therapy (ART) factors did not predict current gross motor function in this study.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Diseases

Background:

  • Human immunodeficiency virus encephalopathy (HIVE) can cause neurological deficits, including spasticity in children.
  • Bilateral lower limb (BLL) spasticity significantly impacts gross motor function in affected children.
  • Understanding factors influencing motor function is crucial for targeted interventions.

Purpose of the Study:

  • To characterize gross motor function in children with HIVE and BLL spasticity.
  • To explore the relationship between early antiretroviral therapy (ART) parameters (age, CD4 percentage, viral load) and current gross motor function.
  • To identify potential predictors of functional outcomes in this population.

Main Methods:

  • A cohort of 30 ambulant children with HIVE and BLL spasticity was studied.
  • Data on clinical parameters, including ART initiation, were extracted from medical records.
  • Gross motor function was quantitatively assessed using the Gross Motor Function Measure (GMFM-88).

Main Results:

  • The study included 14 males and 16 females with a median age of 8 years.
  • ART was initiated early (median 7 months) with significant viral suppression indicated by CD4 percentage and viral load.
  • While overall GMFM-88 scores showed variability, no significant associations were found between ART initiation parameters and gross motor function outcomes.

Conclusions:

  • Gross motor function deficits in children with HIVE and BLL spasticity present a broad spectrum of severity.
  • Early ART initiation parameters, including age, CD4 percentage, and viral load, were not predictive of current gross motor function in this cohort.
  • Further research is needed to identify factors that influence long-term motor outcomes in children with HIVE.
Abstract

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