QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Mintz, M. Search for Related Content PubMed PubMed Citation Articles by Mintz, M.

Neurological and Developmental Problems in Pediatric HIV Infection¹

Cooper Hospital/University Medical Center, Camden, New Jersey 08103

Human immunodeficiency virus type-1 (HIV-1)-associated neurologic disease, known as "HIV-1-associated progressive encephalopathy" (PE), is a common concomitant in the progression towards AIDS. PE, characterized by a triad of symptoms including impaired brain growth, progressive motor dysfunction, and loss or plateau of developmental milestones, is believed to result from both direct and indirect effects of HIV-1 infection on the central nervous system (CNS). Consequent to the hallmark systemic immune deficiency of HIV infection, the CNS becomes susceptible to opportunistic infections which add further morbidity and mortality, and may contribute either directly or indirectly to neurologic symptoms which can often mimic PE. Static encephalopathies (SE) represent fixed, nonprogressive neurologic or neurodevelopmental deficits in HIV-infected children. SE may or may not be caused by HIV infection but are often associated with such identifiable insults as prematurity, in utero exposure to toxins or infectious agents, or head trauma. Additional neurological manifestations of HIV infection are seizures, cerebrovascular complications (i.e., stroke), myelopathies, neuromuscular syndromes, and CNS complications of opportunistic infections. Neurobehavioral aberrations have also been observed in pediatric HIV infection. In addition to the neuropathogenesis, theories regarding the timing and detection of the neurological problems associated with pediatric HIV infection are discussed along with a presentation of current treatment paradigms and their rationales. The importance of identifying the numerous environmental factors, including nutritional status, that may confound the ability to discriminate between a primary or secondary role of HIV infection in the various neurological problems of HIV infection is discussed.

KEY WORDS: • HIV infection • neurological function • progressive encephalopathy • nutrition • neuropathogenesis • opportunistic infections

¹ Presented at the workshop entitled "Nutrition in Pediatric HIV Infection: Setting the Research Agenda" held in Bethesda, MD on September 28–29, 1995. The workshop was sponsored by the Office of AIDS Research of the National Institutes of Health, the National Institute of Child Health and Human Development, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Mental Health, Food and Drug Administration, Pediatric AIDS Foundation, National Dairy Council, Sandoz Nutrition Corporation, Bristol-Meyers Squibb Company, Clintec Nutrition Company, Ross Products Division-Abbott Laboratories, Serono Laboratories, Inc., and the American Institute of Nutrition. Workshop proceedings are published as a supplement to The Journal of Nutrition. Guest Editors for this supplement publication were Daniel J. Raiten and John M. Talbot, Life Sciences Research Office, Federation of American Societies for Experimental Biology, Bethesda, MD.