Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
NEUROLOGY OF HUMAN IMMUNODEFICIENCY VIRUS INFECTION IN CHILDREN
AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 79-101, 1988.. Unique Identifier : AIDSLINE ICDB/89648464 Epstein LG; Sharer LR; Dept. of Neurosciences, Univ. of Medicine and Dentistry of New; Jersey, Medical Sciences Building, Room H506, 100 Bergen St.,; Newark, NJ 07103
Abstract:
Progressive encephalopathy is a common and devastating complication of HIV infection in children. Although it occurs most often in children who have already been diagnosed as having AIDS, progressive encephalopathy may be the first manifestation of HIV infection. The incubation period between exposure to the virus and the onset of neurologic deterioration varies from a few months to 5 years. Progressive encephalopathy is invariably fatal. Clinical neurologic features, radiologic and laboratory findings, gross and microscopic neuropathologic features, and clinicopathological correlations of HIV infection in children are described. The discovery of intra-blood-brain barrier synthesis of HIV-antibody is strong evidence that the virus does invade the brain. The presence of HIV-antigen in the cerebrospinal fluid correlates strongly with the presence of progressive encephalopathy and probably indicates viral expression in brain tissue. It appears that active infection of the brain is part of the spectrum of HIV infection in children. The brain infection probably occurs early and is persistent. HIV most likely is responsible for the progressive encephalopathy seen in children with AIDS. Because of the variable and often prolonged incubation period, it cannot be determined what proportion of children infected with HIV ultimately will develop neurologic sequelae. The presence of HIV in the brain means that antiviral agents developed against HIV infection must cross the blood-brain barrier and that therapy probably will have to be initiated early, perhaps before symptoms occur, to be effective. If the brain proves to be a sanctuary for the virus, lifelong or repeated treatment may be necessary. (70 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*PATHOLOGY Atrophy Brain/PATHOLOGY Brain Diseases/ETIOLOGY/*PATHOLOGY Cerebral Arteries/PATHOLOGY Child Human Neurons/ULTRASTRUCTURE Opportunistic Infections/ETIOLOGY/PATHOLOGY Tomography, X-Ray Computed MONOGRAPH REVIEW, TUTORIAL REVIEW
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
