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NeuroAIDS in children.
Wilmshurst, Jo M; Hammond, Charles K; Donald, Kirsty; Hoare, Jacqueline; Cohen, Karen; Eley, Brian.
Afiliación
  • Wilmshurst JM; Department of Paediatrics, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Electronic address: Jo.wilmshurst@uct.ac.za.
  • Hammond CK; Department of Paediatrics, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
  • Donald K; Department of Paediatrics, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
  • Hoare J; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
  • Cohen K; Division of Clinical Pharmacology, Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.
  • Eley B; Department of Infectious Diseases, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Handb Clin Neurol ; 152: 99-116, 2018.
Article en En | MEDLINE | ID: mdl-29604987
ABSTRACT
The human immunodeficiency virus-1 (HIV-1) enters the central nervous system compartment within the first few weeks of systemic HIV infection and may cause a spectrum of neurologic complications. Without combination antiretroviral therapy (cART), 50-90% of all HIV-infected infants and children develop some form of neuroAIDS. Of the estimated 2.3 million children less than 15 years of age who were living in sub-Saharan Africa at the end of 2014, only 30% were receiving cART, suggesting that there is a large burden of neuroAIDS among HIV-infected children in sub-Saharan Africa. There is complex interplay between the disease process itself, the child's immune reaction to the disease, the secondary complications, the side-effects of antiretroviral drugs, and inadequate antiretroviral drug uptake into the central nervous system. In addition there is the layering effect from the multiple socioeconomic challenges for children living in low- and middle-income countries. Adolescents may manifest with a range of neurocognitive sequelae from mild neurocognitive disorder through to severe neurocognitive impairment. Neuroimaging studies on white-matter tracts have identified dysfunction, especially in the frontostriatal networks needed for executive function. Psychiatric symptoms of depression, attention deficit hyperactivity disorder, and behavioral problems are also commonly reported in this age group. Antiretroviral drugs may cause treatment-limiting neurologic and neuropsychiatric adverse reactions. The following chapter addresses the neurologic complications known to be, and suspected of being, associated with HIV infection in children and adolescents.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Complejo SIDA Demencia / VIH-1 Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Child / Humans Idioma: En Revista: Handb Clin Neurol Año: 2018 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infecciones por VIH / Complejo SIDA Demencia / VIH-1 Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Child / Humans Idioma: En Revista: Handb Clin Neurol Año: 2018 Tipo del documento: Article
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