Neurologic status of human immunodeficiency virus 1-infected infants and their controls: A prospective study from birth to 2 years

Anita L. Belman, Larry R. Muenz, Joseph C. Marcus, James J. Goedert, Sheldon Landesman, Arye Rubinstein, Susan Goodwin, Stephen Durako, Anne Willoughby

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objective. To determine the timing, extent, severity, and persistence of neurologic abnormalities in children with perinatally acquired human immunodeficiency virus 1 (HIV-1) infection compared with similar uninfected children of HIV-1-infected women and control children. Methods. Serial neurologic examinations and head circumference measurements were performed on a cohort of HIV-1-infected children born to HIV-1-infected women, seroreverting children born to HIV-1-infected women, and control children born to uninfected women. Examination data from 32 HIV-1-infected children, 99 reverters, and 116 control children were summarized by eight neurologic domains. Data were analyzed by longitudinal analysis. Results. Reverter children were not different from control children in neurologic function for any of the eight domains or head circumference. HIV-1-infected children had significantly more neurologic problems than the control and reverter children for seven of the eight domains. The HIV-1-infected children were further classified by whether they had acquired immunodeficiency syndrome (AIDS)- defining clinical conditions (other than lymphoid interstitial pneumonitis) in the first 24 months of life (the AIDS-opportunistic infection group) or did not (the infected-other group). Neurologic abnormalities were early, severe, pervasive, and persistent in the AlDS-opportunistic infection group, and nearly all in this group had head circumference measurements below the 10th percentile. The infected-other group had no statistically significant differences from the uninfected children, although individual children in the infected-other group had some abnormalities. Conclusions. In utero exposure to HIV-1 without infection seems to have no negative impact on neurologic function in children in the first 2 years of life. Among children with perinatally acquired HIV-1 infection, the most severe and pervasive neurologic problems occur in those children who have early serious HIV-1 clinical disease. Most children without serious AIDS-defining clinical conditions in the first 2 years of life are also free from serious neurologic problems during that period.

Original languageEnglish (US)
Pages (from-to)1109-1118
Number of pages10
JournalPediatrics
Volume98
Issue number6
StatePublished - Dec 1996

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Nervous System
HIV-1
Parturition
Prospective Studies
Nervous System Malformations
Acquired Immunodeficiency Syndrome
Head
Opportunistic Infections
Virus Diseases
Interstitial Lung Diseases
Neurologic Examination

Keywords

  • central nervous system
  • human immunodeficiency virus 1- associated central nervous system disease
  • human immunodeficiency virus and acquired immunodeficiency syndrome encephalopathy
  • pediatric acquired immunodeficiency syndrome and human immunodeficiency virus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Belman, A. L., Muenz, L. R., Marcus, J. C., Goedert, J. J., Landesman, S., Rubinstein, A., ... Willoughby, A. (1996). Neurologic status of human immunodeficiency virus 1-infected infants and their controls: A prospective study from birth to 2 years. Pediatrics, 98(6), 1109-1118.

Neurologic status of human immunodeficiency virus 1-infected infants and their controls : A prospective study from birth to 2 years. / Belman, Anita L.; Muenz, Larry R.; Marcus, Joseph C.; Goedert, James J.; Landesman, Sheldon; Rubinstein, Arye; Goodwin, Susan; Durako, Stephen; Willoughby, Anne.

In: Pediatrics, Vol. 98, No. 6, 12.1996, p. 1109-1118.

Research output: Contribution to journalArticle

Belman, AL, Muenz, LR, Marcus, JC, Goedert, JJ, Landesman, S, Rubinstein, A, Goodwin, S, Durako, S & Willoughby, A 1996, 'Neurologic status of human immunodeficiency virus 1-infected infants and their controls: A prospective study from birth to 2 years', Pediatrics, vol. 98, no. 6, pp. 1109-1118.
Belman, Anita L. ; Muenz, Larry R. ; Marcus, Joseph C. ; Goedert, James J. ; Landesman, Sheldon ; Rubinstein, Arye ; Goodwin, Susan ; Durako, Stephen ; Willoughby, Anne. / Neurologic status of human immunodeficiency virus 1-infected infants and their controls : A prospective study from birth to 2 years. In: Pediatrics. 1996 ; Vol. 98, No. 6. pp. 1109-1118.
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T2 - A prospective study from birth to 2 years

AU - Belman, Anita L.

AU - Muenz, Larry R.

AU - Marcus, Joseph C.

AU - Goedert, James J.

AU - Landesman, Sheldon

AU - Rubinstein, Arye

AU - Goodwin, Susan

AU - Durako, Stephen

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N2 - Objective. To determine the timing, extent, severity, and persistence of neurologic abnormalities in children with perinatally acquired human immunodeficiency virus 1 (HIV-1) infection compared with similar uninfected children of HIV-1-infected women and control children. Methods. Serial neurologic examinations and head circumference measurements were performed on a cohort of HIV-1-infected children born to HIV-1-infected women, seroreverting children born to HIV-1-infected women, and control children born to uninfected women. Examination data from 32 HIV-1-infected children, 99 reverters, and 116 control children were summarized by eight neurologic domains. Data were analyzed by longitudinal analysis. Results. Reverter children were not different from control children in neurologic function for any of the eight domains or head circumference. HIV-1-infected children had significantly more neurologic problems than the control and reverter children for seven of the eight domains. The HIV-1-infected children were further classified by whether they had acquired immunodeficiency syndrome (AIDS)- defining clinical conditions (other than lymphoid interstitial pneumonitis) in the first 24 months of life (the AIDS-opportunistic infection group) or did not (the infected-other group). Neurologic abnormalities were early, severe, pervasive, and persistent in the AlDS-opportunistic infection group, and nearly all in this group had head circumference measurements below the 10th percentile. The infected-other group had no statistically significant differences from the uninfected children, although individual children in the infected-other group had some abnormalities. Conclusions. In utero exposure to HIV-1 without infection seems to have no negative impact on neurologic function in children in the first 2 years of life. Among children with perinatally acquired HIV-1 infection, the most severe and pervasive neurologic problems occur in those children who have early serious HIV-1 clinical disease. Most children without serious AIDS-defining clinical conditions in the first 2 years of life are also free from serious neurologic problems during that period.

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