title: Neurologic complications of pediatric human immunodeficiency virus: implications for clinical practice and management challenges in the African setting.
abstract: Approximately 3.4 million children worldwide are affected with human immunodeficiency virus (HIV)/AIDS with more than 90% of them residing in sub-Saharan Africa, according to the World Health Organization. A significant proportion of the children eligible for treatment with antiretroviral therapy are not currently receiving it. Neurologic manifestations of HIV are common in both adults and children. There is a large spectrum of neurologic conditions that may be caused by the virus; however, early invasion of the central nervous system by the virus, affecting the developing fetal and infant brain, is believed to result in the most common primary HIV-related central nervous system complication, HIV encephalopathy. This article summarizes the spectrum of neuro-HIV in children, focuses on the neurocognitive and behavioral sequelae, reviews the effects of treatment on the primary neurologic effects of the disease, and discusses the specific challenges of identifying and managing these problems in resource-limited contexts, such as those found on the African continent.
authors.affiliation: Division of Developmental Paediatrics, School of Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Electronic address: Kirsty.Donald@uct.ac.za.
authors.forename: Kirsten Ann
authors.initials: KA
authors.lastname: Donald
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Jackie
authors.initials: J
authors.lastname: Hoare
authors.affiliation: Paediatric Infectious Diseases Unit, School of Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
authors.forename: Brian
authors.initials: B
authors.lastname: Eley
authors.affiliation: Division of Paediatric Neurology, School of Child and Adolescent Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
authors.forename: Jo M
authors.initials: JM
authors.lastname: Wilmshurst
mesh_terms: D000349:Africa / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D009422:Nervous System Diseases / Q000209:etiology* / Q000628:therapy* / Q000821:virology; D009462:Neurology; D010372:Pediatrics