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Seizures in Children with HIV infection in South Africa: A retrospective case control study

R J Burman1, J M Wilmshurst1, S Gebauer2

  • 1Division of Paediatric Neurology, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700 South Africa; University of Cape Town Neuroscience Institute, Faculty of Health Sciences, Anzio Road, Observatory, Cape Town 7295 South Africa.

Seizure
|February 6, 2019
PubMed

Insights

Human immunodeficiency virus (HIV) infection in children is linked to seizures, with meningitis and stroke increasing risk. Efavirenz treatment correlated with poor seizure control in HIV-infected children with epilepsy.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Limited data exists on the role of Human immunodeficiency virus (HIV) in pediatric seizures.
  • Managing seizures in HIV-infected children is complex due to potential drug interactions.

Purpose of the Study:

  • To explore seizure semiology and clinical course in HIV-infected children.
  • To identify risk factors for seizures and factors influencing seizure control in this population.

Main Methods:

  • Retrospective case-control study of HIV-infected children attending an HIV neurology clinic (2008-2015).
  • Multinomial logistic regression used to identify risk factors and seizure control predictors.

Main Results:

  • 23% of 227 HIV-infected children had a history of seizures.
  • Prior bacterial meningitis, cerebrovascular accident (CVA), and tuberculous meningitis (TBM) were significant risk factors for seizures.
  • Generalized tonic-clonic seizures were most common (64%), often infectious in origin (62%).
  • Epilepsy was diagnosed in 62% of patients with seizures.
  • Efavirenz treatment was associated with poor seizure control (OR 23.1, p=0.0001).

Conclusions:

  • New data highlights the complex presentation of seizures in HIV-infected children.
  • Management challenges exist, particularly concerning antiretroviral therapy interactions and seizure control.
Abstract

Keywords:
AnticonvulsantsAntiretroviralsComorbiditiesEpilepsyHIVPaediatricsSeizures

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