title: HIV encephalopathy with bilateral lower limb spasticity: gross motor function and antiretroviral therapy.
abstract: To describe gross motor function in children with bilateral lower limb (BLL) spasticity due to human immunodeficiency virus encephalopathy (HIVE), and to investigate the association between age, CD4 percentage, and viral load at initiation of antiretroviral therapy (ART) and current gross motor function.
  
  
  
  Thirty ambulant children with HIVE and BLL spasticity were recruited. Clinical parameters, including ART, were obtained from medical records. Gross motor function was assessed using the 88-item Gross Motor Function Measure (GMFM-88).
  
  
  
  The participant group was comprised of 14 males and 16 females (median age 8y; interquartile range [IQR] 7-11y). ART was initiated at a median age of 7 months (IQR 5-11mo) with a median CD4 percentage of 4.7% (IQR 2.3-8.0) and viral load of log106.0 (IQR 5.6-6.4). The median total GMFM-88 score was 89% (IQR 78-94%), with a wide range of scores in the 'Standing' domain (26-97%) and 'Walking, Running, and Jumping' domain (8-99%). No associations were detected between age at initiation of ART, CD4 percentage, or viral load and total GMFM-88 score.
  
  
  
  Limitations in gross motor function in children with HIVE and BLL spasticity range from mild to severe. ART initiation factors were not able to predict functional status in this sample.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.|Division of Orthopedic Surgery, Department of Surgical Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa.
authors.forename: Theresa N
authors.initials: TN
authors.lastname: Mann
authors.affiliation: Children's Infectious Diseases Clinical Research Unit, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
authors.forename: Barbara
authors.initials: B
authors.lastname: Laughton
authors.affiliation: Division of Developmental Pediatrics, Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Donald
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of Cape Town, Cape Town, South Africa.
authors.forename: Nelleke G
authors.initials: NG
authors.lastname: Langerak
mesh_terms: D015526:AIDS Dementia Complex / Q000150:complications* / Q000188:drug therapy*; D044966:Anti-Retroviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D009128:Muscle Spasticity / Q000188:drug therapy / Q000209:etiology*; D017063:Outcome Assessment, Health Care; D012720:Severity of Illness Index
chemical_list: D044966:Anti-Retroviral Agents