title: Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease.
abstract: OBJECTIVE
  To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests.
  
  
  METHODS
  Consecutive case series.
  
  
  METHODS
  Government medical research center.
  
  
  METHODS
  Eighty-six previously untreated children with symptomatic HIV-1 disease.
  
  
  RESULTS
  CD4% measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4% measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01).
  
  
  CONCLUSIONS
  Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.
authors.affiliation: Pediatric Branch, National Cancer Institute, NIH Clinical Center, Bethesda, MD 20892-1928, USA.
authors.forename: P
authors.initials: P
authors.lastname: Brouwers
authors.forename: G
authors.initials: G
authors.lastname: Tudor-Williams
authors.forename: C
authors.initials: C
authors.lastname: DeCarli
authors.forename: H A
authors.initials: HA
authors.lastname: Moss
authors.forename: P L
authors.initials: PL
authors.lastname: Wolters
authors.forename: L A
authors.initials: LA
authors.lastname: Civitello
authors.forename: P A
authors.initials: PA
authors.lastname: Pizzo
mesh_terms: D015526:AIDS Dementia Complex / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D016655:HIV Core Protein p24 / Q000032:analysis; D015497:HIV-1; D006801:Humans; D007223:Infant; D008297:Male; D009483:Neuropsychological Tests; D014057:Tomography, X-Ray Computed
chemical_list: D016655:HIV Core Protein p24