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Neurologic Abnormalities in HIV-1 Infected Children in the Era of Combination Antiretroviral Therapy

By van Arnhem Lotus A., Bunders Madeleine J., Scherpbier Henriette J., Majoie Charles B. L. M., Reneman Liesbeth, Frinking Olivier, Poll-The Bwee Tien, Kuijpers Taco W. and Pajkrt Dasja

Abstract

Pediatric HIV-1 infection is associated with neurologic abnormalities. In recent years, the neurological outcome of HIV-1 infected children has substantially improved with combination antiretroviral therapy (cART). However, data regarding the long-term effect of cART and neurologic outcome are limited. T cell count, HIV-1 viral load in blood and cerebrospinal fluid (CSF), and duration of cART as well as neurological examination.Abnormal neurologic examinations in these HIV-1 infected children included language impairment (22%), abnormal muscle tone (hyper/hypotonia) (14%) and delay in reaching developmental milestones (12%). Ventricular enlargement and sulcal widening (29%) and white matter lesions (38%) were prominent findings. White matter lesions were positively correlated with HIV-1 viral load levels. In a small follow-up sub study white matter lesions did not improve while children with ventricular enlargement and sulcal widening showed improvements whilst being treated with cART.In the current era of cART HIV-1 infected children still frequently show neurological impairments together with abnormal neuro-imaging

Publisher: Public Library of Science
Year: 2013
DOI identifier: 10.1371/journal.pone.0064398
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