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Neurodevelopmental outcomes in children with HIV infection under 3 years of age

  • CJ Foster (a1), RL Biggs (a1), D Melvin (a1), MDS Walters (a1), G Tudor-Williams (a1) and EGH Lyall (a1)...

Abstract

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 6mo). 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 7y 3mo); however, abnormal neurological signs and significant gross motor difficulties persisted.

Copyright

Corresponding author

The Family Clinic, St Mary's Hospital, Praed Street, London W2 1NY, UK. E-mail: hermione.lyall@st-marys.nhs.uk

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