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Neuroophthalmological examination in children with AIDS
A F Constantinescu1, S M Ruţă, S N Constantinescu
1Department of Ophthalmology, Witting Hospital, Bueharest, Romania.
Insights
Early neuro-ophthalmological signs like nystagmus and visual memory impairment in children with AIDS may precede detectable central nervous system viral load. These findings correlate with specific Western Blot profiles, aiding in early disease status evaluation.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Ophthalmology
Background:
- Evaluating HIV disease status requires physical and laboratory examinations, considering changes from baseline and age-adjusted values.
- Neurodevelopmental assessment is crucial for children with Acquired Immunodeficiency Syndrome (AIDS).
Purpose of the Study:
- To compare neuro-ophthalmological assessment results with Western Blot (WB) profiles in the cerebrospinal fluid (CSF) of children with AIDS.
- To identify early indicators of encephalopathy in children with HIV.
Main Methods:
- Neuro-ophthalmological examinations were performed on 54 children with AIDS, classified into encephalopathy positive (n=44) and negative (n=10) groups using the Denver Developmental Screening Test (DDST).
- Results were correlated with Western Blot profiles and p24 antigen levels in CSF.
Main Results:
- Two neuro-ophthalmological findings, nystagmus on following and visual memory impairment, were observed early in the encephalopathy-free group.
- These early signs correlated with a lower gag score on Western Blot, indicating a loss of gag bands.
- No correlation was found between these findings and the p24 antigen level in CSF.
Conclusions:
- Early neuro-ophthalmological changes can be associated with specific Western Blot patterns in children with AIDS, even before significant p24 antigen is detected in CSF.
- These findings suggest potential for earlier detection of neurological involvement in pediatric HIV.
- Further research is warranted to explore the predictive value of these neuro-ophthalmological markers.
Abstract:
Evaluation of HIV disease status includes physical examination (anthropomorphic measurements, neurological assessment, etc.) and laboratory examination. Consideration should be given to changes from baseline values, age adjusted normal values and the rapidity of changes. Here we compare results of neuroophthalmologic assessment with Western Blo (WB) profiles in cerebrospinal fluids (CSF) of 54 children with AIDS. Children were classified by Denver Developmental Screening Test (DDST) administration in encephalopathy positive (n = 44) and encephalopathy negative (n = 10) groups. Neuroophthalmological examination which included nine items with good test-retest reliability showed that two of them (nystagmus on following and visual memory impairment) appeared early in the encephalopathy free group and correlated with the loss of some gag band in Western Blot (lower gag score). No correlation was however, found with respect to p24 antigen level in cerebrospinal fluid, a marker which reflects CNS viral load.