Vertical human immunodeficiency virus-1 infection: involvement of the central nervous system and treatment.
Involvement of the central nervous system (CNS) contributes substantially to morbidity and mortality of vertical infection with the human immunodeficiency virus (HIV)-1. The clinical spectrum ranges from minor developmental disabilities to severe and progressive encephalopathy. Progression of the disease varies considerably. Both direct viral and indirect host-related pathogenic mechanisms have been proposed. The diagnosis depends on neurological and neurodevelopmental assessments. So far, HIV-1-specific antiviral treatment has shown limited effects on neurological manifestations in symptomatic children. Thus, efforts are needed to improve prevention and treatment of CNS involvement. It is still unclear whether early use of antiretroviral agents is of benefit.


CONCLUSIONS
Since experience of treatment of HIV-1 infections in adults cannot easily be translated to children, paediatric clinical trials are needed to answer questions specific to the unique characteristics of children.
Exhenry
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C
Infectious Diseases Unit, University Children's Hospital of Zurich, Switzerland.
Nadal
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D
D015526:AIDS Dementia Complex / Q000175:diagnosis / Q000209:etiology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000188:drug therapy / Q000635:transmission*; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001284:Atrophy; D001921:Brain / Q000473:pathology; D002493:Central Nervous System Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D015497:HIV-1; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008279:Magnetic Resonance Imaging; D008582:Meningitis, Aseptic / Q000209:etiology; D014057:Tomography, X-Ray Computed
D000998:Antiviral Agents