Developmental Medicine & Child Neurology



Original Articles

Neurodevelopmental outcomes in children with HIV infection under 3 years of age


CJ Foster  a1, RL Biggs  a1, Melvin  a1, MDS Walters  a1, Tudor-Williams  a1 and EGH Lyall  a1 c1
a1 The Family Clinic, St Mary's Hospital, Praed Street, London, UK.

Abstract

Following the introduction of combination antiretroviral therapy, children vertically infected with the human immunodeficiency virus (HIV-1) living in the developed world are surviving into adult life. This paper reviews the neurodevelopmental outcomes of 62 consecutively-presenting children with HIV-1 infection diagnosed before 3 years of age (32 males, 30 females; median age at presentation 6mo). Neurological and developmental data are presented with immunological and virological responses to antiretroviral therapy. Fourteen children (22%) had abnormal neurological signs and 25 (40%) demonstrated significant developmental delay on standardized developmental assessments. Children presenting with more severe HIV-1 disease and immune compromise had significantly more abnormal neurological signs and developmental delays than children presenting with milder HIV-1 symptomatology. Immune function, control of HIV-1 viral replication, and growth parameters improved with antiretroviral therapy (median age at last follow-up 7y 3mo); however, abnormal neurological signs and significant gross motor difficulties persisted.

(Published Online July 12 2006)
(Accepted December 23 2005)


Correspondence:
c1 The Family Clinic, St Mary's Hospital, Praed Street, London W2 1NY, UK. E-mail: hermione.lyall@st-marys.nhs.uk