title: Stable human immunodeficiency virus encephalopathy in two infants receiving early intravenous gammaglobulin plus antimicrobial prophylaxis.
abstract: Two infants with human immunodeficiency virus (HIV) infection, encephalopathy, intrathecal anti-HIV IgG antibody production and (in one case) the presence of HIV antigen received monthly doses of intravenous gammaglobulin (IVGG) and daily antimicrobial prophylaxis starting at the ages of 6 and 9 months respectively. The follow-up over 15 and 12 months revealed a favourable course with remarkable improvement in visuo-spatial functions, receptive language, play behaviour and fine motor skills, as well as in muscle tone, pyramidal tract signs and vigilance in case 1, and near normalization in case 2. Viability of HIV in peripheral blood mononuclear cells, antigen in serum and cellular immunodeficiency, however, all remained unchanged. We suggest that neurological complications of encephalopathy in paediatric acquired immunodeficiency syndrome may have a slower progression when IVGG treatment plus antimicrobial prophylaxis is started early.
authors.affiliation: Kinderspital, Medizinische Klinik, Zürich, Switzerland.
authors.forename: U A
authors.initials: UA
authors.lastname: Hunziker
authors.forename: D
authors.initials: D
authors.lastname: Nadal
authors.forename: J B
authors.initials: JB
authors.lastname: Jendis
authors.forename: Z
authors.initials: Z
authors.lastname: Tomasik
authors.forename: J C
authors.initials: JC
authors.lastname: Wetzel
authors.forename: J
authors.initials: J
authors.lastname: Schüpbach
authors.forename: R A
authors.initials: RA
authors.lastname: Seger
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000151:congenital / Q000276:immunology / Q000628:therapy; D001927:Brain Diseases / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D004338:Drug Combinations / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015483:HIV Antibodies / Q000032:analysis; D015488:HIV Antigens / Q000032:analysis; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage* / Q000627:therapeutic use; D016756:Immunoglobulins, Intravenous; D007223:Infant; D007231:Infant, Newborn; D007654:Ketoconazole / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D009460:Neurologic Examination; D009894:Opportunistic Infections / Q000517:prevention & control; D013420:Sulfamethoxazole / Q000008:administration & dosage* / Q000627:therapeutic use; D014295:Trimethoprim / Q000008:administration & dosage* / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
chemical_list: D004338:Drug Combinations; D015483:HIV Antibodies; D015488:HIV Antigens; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D007654:Ketoconazole