title: Resolved lower limb muscle tone abnormalities in children with HIV encephalopathy receiving standard antiretroviral therapy.
abstract: BACKGROUND
  This short report arose from a follow-up study of children previously diagnosed with human immunodeficiency virus (HIV) encephalopathy and spastic diplegia and is among the first to describe that increased lower limb muscle tone in children with a confirmed HIV encephalopathy diagnosis may resolve over time in some cases.
  
  
  RESULTS
  Of 19 children previously diagnosed with HIV encephalopathy and increased lower limb muscle tone, some were found to have resolved muscle tone abnormalities during a follow-up physical examination [resolved group, n = 13, median age 9 years 7 months (interquartile range 7 years 3 months-10 years 9 months)] whereas others continued to show increased lower limb muscle tone at follow-up [unresolved group, n = 6 median age 8 years 6 months (interquartile range 7 years 9 months-9 years 7 months)]. A review of clinical records showed no significant differences in age or follow-up time between the resolved and unresolved groups. However, the unresolved group appeared to have severe disease at an earlier age than the resolved group, based on the age at antiretroviral treatment initiation [median age at start of treatment 2 years 3 months (interquartile range 7 months-5 years 3 months) vs. 8 months (interquartile range 6-12 months), p = 0.08] and had more severe neurological signs at the initial assessment.
  
  
  CONCLUSIONS
  It is anticipated that this information may be of immediate value to those involved in the treatment of children with HIV encephalopathy and increased lower limb muscle tone whilst awaiting the outcome of future controlled clinical trials.
authors.affiliation: Division of Neurosurgery, Department of Surgery, H53 Old Main Building, Groote Schuur Hospital, University of Cape Town, Observatory 7925, Cape Town, South Africa ; Division of Orthopaedic Surgery, Department of Surgical Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa.
authors.forename: Theresa N
authors.initials: TN
authors.lastname: Mann
authors.affiliation: Division of Developmental Pediatrics, Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa ; Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Donald
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics and Child Health, University of Cape Town, Cape Town, South Africa ; Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
authors.forename: Kathleen G
authors.initials: KG
authors.lastname: Walker
authors.affiliation: Division of Neurosurgery, Department of Surgery, H53 Old Main Building, Groote Schuur Hospital, University of Cape Town, Observatory 7925, Cape Town, South Africa.
authors.forename: Nelleke G
authors.identifier: 0000-0003-1567-3112
authors.initials: NG
authors.lastname: Langerak
keywords: HIV encephalopathy; Pediatric HIV; Spastic diplegia