Objective: To describe neurologic outcomes in children infected with HIV in t he era of highly active anti- retroviral therapy (HAART), including rates of pr ogressive HIV encephalopathy (PHE) and clinical sequelae am...Objective: To describe neurologic outcomes in children infected with HIV in t he era of highly active anti- retroviral therapy (HAART), including rates of pr ogressive HIV encephalopathy (PHE) and clinical sequelae among PHE survivors. St udy design: Neurobehavior and school placement was assessed prospectively in the year 2000 in 126 children infected with HIV. PHE, developmental delay, and atte ntion deficit disorder (ADHD) were the main outcome variables analyzed. Predicto rs of PHE were assessed in controlled analysis among age- matched controls. Res ults: The rate of active PHE in 2000 was 1.6% (n = 2), and the prevalence of a rrested PHE was 10% (n = 13). Residual motor and cognitive sequelae and need f or special education was found in the majority of survivors. PHE relapse occurre d in 3 (23% ) children with previously arrested PHE. Viral load (VL) was the on ly significant factor associated with PHE.HIV or PHE was not associated with ADH D. Isolated developmental delay was not associated with HIV. Conclusions: PHE is an infrequent and reversible complication of HIV infection that responds to HAA RT and that may relapse if control of the virus is lost. Children with arrested PHE show higher rates of residual neurologic, cognitive, and scholastic impairme nts compared with children who never had PHE. Children with arrested PHE are the group of children with HIV infectionmost at risk for PHE, in the form of a rela pse.展开更多
文摘Objective: To describe neurologic outcomes in children infected with HIV in t he era of highly active anti- retroviral therapy (HAART), including rates of pr ogressive HIV encephalopathy (PHE) and clinical sequelae among PHE survivors. St udy design: Neurobehavior and school placement was assessed prospectively in the year 2000 in 126 children infected with HIV. PHE, developmental delay, and atte ntion deficit disorder (ADHD) were the main outcome variables analyzed. Predicto rs of PHE were assessed in controlled analysis among age- matched controls. Res ults: The rate of active PHE in 2000 was 1.6% (n = 2), and the prevalence of a rrested PHE was 10% (n = 13). Residual motor and cognitive sequelae and need f or special education was found in the majority of survivors. PHE relapse occurre d in 3 (23% ) children with previously arrested PHE. Viral load (VL) was the on ly significant factor associated with PHE.HIV or PHE was not associated with ADH D. Isolated developmental delay was not associated with HIV. Conclusions: PHE is an infrequent and reversible complication of HIV infection that responds to HAA RT and that may relapse if control of the virus is lost. Children with arrested PHE show higher rates of residual neurologic, cognitive, and scholastic impairme nts compared with children who never had PHE. Children with arrested PHE are the group of children with HIV infectionmost at risk for PHE, in the form of a rela pse.
