Neurological manifestations of acquired immunodeficiency syndrome in children

The incidence, transmission, diagnosis, classification and systemic aspects of human immunodeficiency virus-type 1 (HIV-1) infection in the pediatric population are discussed. We have reviewed the clinical, neuropathologic, radiologic, laboratory and pathogenic mechanisms of the neurologic manifestations HIV-1 infection. In our cohort of 159 children with HIV-1 infection, we have retrospectively found an overall incidence of progressive encephalopathy of 55% (87/159), or 74% (87/118) in children with the acquired immunodeficiency syndrome (AIDS). Impaired brain growth (93%), progressive motor dysfunction (90%), and loss or plateau of developmental milestones (76%) were the predominant findings in children with progressive encephalopathy (N = 87). The diagnosis of progressive encephalopathy bears a grim prognosis, with a retrospective mortality of 60%, compared to 47% with a diagnosis of AIDS alone, in our cohort. Various treatment regimens are discussed.