Neurodevelopmental outcomes in children with HIV infection under 3 years of age.
Following the introduction of combination antiretroviral therapy, children vertically infected with the human immunodeficiency virus (HIV-1) living in the developed world are surviving into adult life. This paper reviews the neurodevelopmental outcomes of 62 consecutively-presenting children with HIV-1 infection diagnosed before 3 years of age (32 males, 30 females; median age at presentation 6 mo). Neurological and developmental data are presented with immunological and virological responses to antiretroviral therapy. Fourteen children (22%) had abnormal neurological signs and 25 (40%) demonstrated significant developmental delay on standardized developmental assessments. Children presenting with more severe HIV-1 disease and immune compromise had significantly more abnormal neurological signs and developmental delays than children presenting with milder HIV-1 symptomatology. Immune function, control of HIV-1 viral replication, and growth parameters improved with antiretroviral therapy (median age at last follow-up 7 y 3 mo); however, abnormal neurological signs and significant gross motor difficulties persisted.
Foster
C J
CJ
The Family Clinic, St Mary's Hospital, Praed Street, London, UK.
Biggs
R L
RL
Melvin
D
D
Walters
M D S
MD
Tudor-Williams
G
G
Lyall
E G H
EG
D015526:AIDS Dementia Complex / Q000188:drug therapy / Q000517:prevention & control*; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D002657:Child Development; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology / Q000635:transmission; D015497:HIV-1 / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D019562:Viral Load
D019380:Anti-HIV Agents