Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease.
AIDS. 1995 Jul;9(7):713-20. Unique Identifier : AIDSLINE MED/96035234 Brouwers P; Tudor-Williams G; DeCarli C; Moss HA; Wolters PL; Civitello LA; Pizzo PA; Pediatric Branch, National Cancer Institute, NIH Clinical Center,; Bethesda, MD 20892-1928, USA.
Abstract:
OBJECTIVE: To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests. DESIGN: Consecutive case series. SETTING: Government medical research center. PATIENTS: Eighty-six previously untreated children with symptomatic HIV-1 disease. RESULTS: CD4% measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4% measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01). CONCLUSIONS: Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.
Keywords: Adolescence AIDS Dementia Complex/*DIAGNOSIS/PHYSIOPATHOLOGY/RADIOGRAPHY Brain/RADIOGRAPHY Child Child, Preschool CD4 Lymphocyte Count Female Human HIV Core Protein p24/ANALYSIS HIV-1 Infant Male Neuropsychological Tests Tomography, X-Ray Computed JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.
