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[Cerebral symptoms in pre- or perinatally HIV-infected children]
S Koch1, M Vocks-Hauck, S Henning
1Kinderklinik und Poliklinik Kaiserin-Auguste-Victoria-Haus, Universitätsklinikum Rudolf Virchow, Berlin.
Insights
Pediatric HIV infection frequently causes neurological symptoms, impacting motor, cognitive, and language development. Early onset HIV encephalopathy leads to severe disability and mortality in affected children.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Developmental Pediatrics
Context:
- Human Immunodeficiency Virus (HIV) infection in children presents significant health challenges.
- Neurological complications are a major concern in vertically transmitted HIV.
- Understanding the progression of HIV-related neurological disease in infants is crucial.
Purpose:
- To describe the neurological manifestations and disease progression in pre- or perinatally HIV-infected children.
- To identify potential risk factors influencing the severity of neurological symptoms.
- To analyze the impact of HIV infection on child development.
Summary:
- Eight of 13 children with perinatal HIV infection developed neurological symptoms, primarily affecting motor functions.
- All affected children exhibited impaired motor, cognitive, and language development; three with HIV encephalopathy experienced developmental regression and died.
- Symptoms appeared within the first year, with faster progression in severe cases, irrespective of identifiable risk factors.
Impact:
- Highlights the high incidence of neurological sequelae in pediatric HIV.
- Underscores the critical impact of HIV on neurodevelopmental outcomes.
- Emphasizes the need for early diagnosis and intervention in pediatric HIV cases.
Abstract:
Eight of 13 children pre- or perinatally infected with the HIV virus subsequently developed neurological symptoms. Three children also had other nonspecific symptoms (fever, lymphadenopathy, diarrhoea, hepatosplenomegaly, failure to thrive and mucocutaneous thrush). Five children developed illnesses associated with AIDS (opportunistic infections, cachexia and lymphocytic interstitial pneumonia). The neurological abnormalities predominantly affected motor functions, only later also involving sensory ones. Motor, cognitive and language development was impaired in all eight children. A loss of developmental milestones occurred in three children with HIV encephalopathy: they have since died. In all the children the HIV infection caused symptoms within the first year, progressing more quickly in the three with encephalopathy. There were no discernible risk factors to account for the difference in the course of the disease.