NeuroAIDS in children

Wilmshurst, Jo M.; Hammond, Charles; Donald, Kirsten A.; Hoare, Jacqueline; Cohen, Karen; Eley, Brian

doi:10.1016/b978-0-444-63849-6.00008-6

Cited by 30 publications

(22 citation statements)

References 113 publications

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“…45 Although there is significant literature on HIV-associated cerebrovascular disease, its precise mechanism is not known. 24,36,46 Adult studies have found that stroke is not common in HIV without an additional underlying disease state. 47 These disease states include infections including varicella zoster virus, 42 cryptococcus, 48,49 neurocysticercosis, 50 hepatitis B, 51 syphilis, 52 and tuberculosis, 53 as well as neoplastic and prothrombotic states.…”

Section: Discussionmentioning

confidence: 99%

“…By convention, impairment was classified as a GDS score !0.5. [21][22][23][24] Neuroimaging Study participants underwent MRI on a 1.5T Siemens Magnetom Essenza scanner (Erlangen, Germany) located at the Cancer Disease Hospital, in Lusaka, Zambia, using a four-channel head coil. No sedation or contrast agents were used.…”

Section: Categorization Of Cognitive Impairmentmentioning

confidence: 99%

“…22,24,36,57e61 However, it is an open question as to whether earlier treatment may paradoxically increase the risk of cerebrovascular disease, for example, due to longer exposure to protease inhibitors. 24,58 Conclusions HIV-associated cognitive impairment is associated with organic brain differences that are detectable on neuroimaging. These neuroimaging changes may be useful to investigate the pathophysiology of structural and cerebrovascular change in Zambian pediatric patients with HIV and may serve as biomarkers in future intervention studies.…”

Section: Limitations Bias Confounding and Generalizabilitymentioning

confidence: 99%

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Brain Magnetic Resonance Imaging Findings Associated With Cognitive Impairment in Children and Adolescents With Human Immunodeficiency Virus in Zambia

Dean

Buda

Adams

et al. 2020

Pediatric Neurology

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Background: Cognitive impairment is common in children and adolescents with human immunodeficiency virus (HIV). Brain magnetic resonance imaging (MRI) is a potentially useful tool to investigate the pathophysiology of HIV-associated cognitive impairment and may serve as a biomarker in future clinical trials. There are few published data on brain imaging in children with HIV in sub-Saharan Africa. Methods: Thirty-four perinatally infected subjects with HIV and age-matched HIV-exposed uninfected controls between the ages nine and 17 years were recruited from the Pediatric Center of Excellence in Lusaka, Zambia, as part of the HIV-associated Neurocognitive Disorders in Zambia study. Brain MRI sequences were acquired, and clinical and volumetric assessments were performed. Subjects underwent a comprehensive neuropsychologic battery, and cognitive impairment status was classified using a global deficit score approach. Regression models were used to evaluate relationships between MRI findings and cognitive function. Results: We identified cerebrovascular disease in seven of 34 subjects with HIV compared with zero of 17 controls (21% vs 0%, P ¼ 0.04). We also identified decreased total brain volumes (1036 vs 1162 cm 3 , P ¼ 0.03) and decreased cortical thickness in the right temporal lobes (3.12 vs 3.29 mm; P ¼ 0.01) and right fusiform gyri (3.10 vs 3.25 mm; P ¼ 0.02) of HIV-infected subjects with cognitive impairment. Conclusions: These findings support the hypothesis that brain volumes may be useful biomarkers for cognitive outcomes in children with HIV. Further studies are necessary to investigate mechanisms of cerebrovascular disease and volume loss in children with HIV.

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Section: Discussionmentioning

confidence: 99%

Section: Categorization Of Cognitive Impairmentmentioning

confidence: 99%

Section: Limitations Bias Confounding and Generalizabilitymentioning

confidence: 99%

See 1 more Smart Citation

Brain Magnetic Resonance Imaging Findings Associated With Cognitive Impairment in Children and Adolescents With Human Immunodeficiency Virus in Zambia

Dean

Buda

Adams

et al. 2020

Pediatric Neurology

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“…Neurological, developmental and behavioural problems in CLHIV have been well-established as devastating consequences of HIV infection, ranging from cognitive deficits to HIV encephalopathy, [41][42][43] and these are associated with neuro-radiological findings. [44,45] Since the introduction of paediatric ART, studies have continued to document neurodevelopmental impairment.…”

Section: Early Neurodevelopmentmentioning

confidence: 99%

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa

et al. 2019

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“…Patients with witnessed seizures need long-term periodic medication control, making it a challenge for clinical drug management. In pediatric patients living with HIV, seizures or epilepsy may be concurrent with brain development delay or neuron-cognitive impairment [ 4 ]. Besides, HIV-seropositive patients with documented seizures are at a higher risk of developing other CNS syndromes, compared with the HIV-negative patients [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Current epidemiological and etiological characteristics and treatment of seizures or epilepsy in patients with HIV infection

Chen

Zhou

Jiang

et al. 2020

Acta Epileptologica

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Seizures or epilepsy is one of the common serious complications in patients with advanced human immunodeficiency virus (HIV) infection or diagnosed with immune deficiency syndrome, with higher incidence and prevalence than in the general population. Generalized seizures are the most common type in the patients. Opportunistic infections are a stereotypical predisposing factor for seizures in HIV patients, but a variety of pathogenic factors can also be found in these patients, such as metabolic perturbation and drug-drug interactions. The diagnostic criteria for seizures in these patients are the same as those in the general population. As HIV patients with seizures need to take both antivirals and antiepileptic drugs, the risk of drug-drug interactions is greatly increased, and the side effects of drugs may also become more prominent. At present, most experience in antiepileptic drug usage has come from the general population, and there is still a lack of guidance of antiepileptic drug use in special groups such as the HIV-infected people. Unlike the old-generation drugs that involve metabolisms through CYP450, the first-line antiepileptic drugs usually bypass CYP450, thus having less drug-drug interactions. In this review, we summarize the recent research progress on the above-mentioned widely discussed topics and make a prospect on future research direction.

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NeuroAIDS in children

Cited by 30 publications

References 113 publications

Brain Magnetic Resonance Imaging Findings Associated With Cognitive Impairment in Children and Adolescents With Human Immunodeficiency Virus in Zambia

Brain Magnetic Resonance Imaging Findings Associated With Cognitive Impairment in Children and Adolescents With Human Immunodeficiency Virus in Zambia

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa

Current epidemiological and etiological characteristics and treatment of seizures or epilepsy in patients with HIV infection

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