Neurological and neurocognitive function of HIV-infected children commenced on antiretroviral therapy

Abstract

Aim: To describe the effect of HIV infection on neurological and neurocognitive function in children commenced on antiretroviral therapy (HAART) and their short-term response to therapy

Methods: In this prospective study, 39 children (15 females) were evaluated before the start of HAART and 30 reassessed 6 months later. The subjects were evaluated with a range of cognitive tests used in every-day clinical practice.

Results: At enrolment, the mean (± SD) age was 60 ± 46 months, 17(44%) and 22(56%) had CDC clinical category B and C disease respectively, and 36(92%) had severe immunosuppression. At the start of HAART no child had cranial nerve or cerebellar dysfunction, but 13/29(33.3%) had evidence of motor dysfunction. By 6 months 1 child had developed cerebellar dysfunction, but there was no statistically significant change in the frequency of motor dysfunction. Mean baseline performances on cognitive testing were generally subnormal. Between 33% and 81% of the children recorded sub-normal intelligence quotients on various cognitive tests. Mean performances did not change significantly after 6 months of HAART.

Conclusion: Neurological and neurocognitive deficits are frequent in HIV-infected children. The prevalence and extent of deficits did not change significantly in response to short-term HAART, indicating neither spontaneous improvement nor deterioration during early treatment.