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Incidence
and Prevalence of HIV Encephalopathy in HIV Positive Children Receiving
HAART
The objective of the current study
was to describe neurologic
outcomes in children infected with HIV in the HAART era,
including rates of progressive HIV encephalopathy (PHE)
and clinical outcomes among PHE survivors.
Neuro-behavior and school placement was assessed prospectively
in the year 2000 in 126 children infected with HIV.
PHE, developmental delay, and attention deficit disorder (ADHD)
were the main outcome variables analyzed. Predictors of PHE were
assessed in controlled analysis among age-matched controls.
Results
·
The
rate of active PHE in 2000 was 1.6% (n = 2), and the prevalence
of arrested PHE was 10% (n = 13).
·
Residual
motor and cognitive sequelae and need for special education was
found in the majority of survivors.
·
PHE
relapse occurred in 3 (23%) children with previously arrested PHE.
·
Viral
load (VL) was the only significant factor associated with PHE.
·
HIV
or PHE was not associated with ADHD.
·
Isolated
developmental delay was not associated with HIV.
Conclusions
In conclusion, the authors write, “PHE is an infrequent and
reversible complication of HIV infection that responds to HAART
and that may relapse if control of the virus is lost. Children with
arrested PHE show higher rates of residual neurologic, cognitive,
and scholastic impairments compared with children who never had
PHE.”
“Children with arrested PHE are the group of children with
HIV infection most at risk for PHE, in the form of a relapse.”
03/23/05
Reference
C A Chiriboga and others. Journal of Pediatrics 146(3):
402-407. March 2005.
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