Bone mineral density increases in HIV-infected children treated with long-term combination antiretroviral therapy

The long-term treatment of human immunodeficiency virus (HIV)-infected children with combination antiretroviral therapy (cART) requires assessment of potential adverse effects, such as osteoporosis. Longitudinal data on bone mineral density (BMD) in HIV-infected children showed that cumulative treatment with cART had a positive impact on BMD over tim

Neurologic abnormalities in HIV-1 infected children in the era of combination antiretroviral therapy

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. In the Pediatric Amsterdam Cohort on HIV-1 study, 59 perinatally HIV-1 infected children were evaluated from 1992-2010. All children underwent neurological examination and neuro-imaging studies, including CT-scan and/or MRI imaging. Fisher exact and Kruskal-Wallis tests were used to compare clinical deviations of neuro-imaging studies with HIV-1 related parameters, including CD4(+) 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-imagin

Associations between ventricular enlargement and/or sulcal widening and white matter lesions and neurologic examination HIV-1 infected children.

<p>Statistical comparisons were made by using Fisher’s exact test for categorical data.</p><p>CT, computed tomography; MRI, magnetic resonance imaging.</p

Characteristics of the 59 children at baseline, at time of first neuro-imaging.

<p>ART, antiretroviral therapy; PI, protease inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; VL, viral load;</p>1<p>Other included Asian ethnicity or unknown.</p

Neuro-imaging abnormalities and associations with HIV-1-related parameters.

<p>Continuous data are described as median and interquartile ranges. Statistical comparisons were made by using Fisher’s exact test for categorical data and the Kruskal-Wallis test for continuous data. AIDS, acquired immunodeficiency syndrome; HIV VL, HIV viral load; CSF, cerebrospinal fluid; cART, combination antiretroviral therapy; PI, protease inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; CT, computed tomography; MRI, magnetic resonance imaging.</p