Features of nervous system damage in children with HIV infection

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Objective. Identification of the clinical features of neurological disorders in children receiving effective antiretroviral therapy (ART).

Materials and methods. A comprehensive examination of 314 children under 18 years of age with HIV infection including a somatoneurological examination, neuropsychological testing, magnetic resonance imaging (MRI) of the brain, electroencephalography (EEG), viral load and immune status testing, as well as treatment of neurological disorders was conducted.

Results. The overall frequency of neurological disorders was 79.4%; muscle hypotonia (79%), speech disorders (55%), general cerebral disorders (44%) were dominant ones. The frequency of cognitive impairment was 73.9% with a predominance of attention (62%) and memory (43%) disorders. Social adaptation disorders were detected in 46% of children. Neuroimaging revealed HIV-specific changes in 51% of children. Changes in EEG were noted in 76% of children. HIV encephalopathy was diagnosed in 61% of children. Statistical relationships between the changes detected by MRI of the brain and latent paresis detected during neurological examination were found.

Conclusion. Despite effective ART, neurological pathology and cognitive impairment remain common HIV-associated manifestations in children, which, in the absence of timely diagnosis and treatment/correction, leads to an unfavorable outcome of the disease.

全文:

受限制的访问

作者简介

Aleksey Minin

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia; St. Petersburg State Pediatric Medical University, Ministry of Health of the Russia

编辑信件的主要联系方式.
Email: aleksey_minin@mail.ru
ORCID iD: 0009-0000-7560-9214

Cand. Med. Sci., Neurologist, Associate Professor, Department of Neonatology with Courses in Neurology and Obstetrics and Gynecology

俄罗斯联邦, St. Petersburg; St. Petersburg

Larisa Afonina

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia; I.I. Mechnikov North-West State Medical University, Ministry of Health of the Russia

Email: alarissa-ridh@rambler.ru

Cand. Med. Sci., Senior Researcher, Department of Scientific and Methodological Work and Medical and Social Assistance, Associate Professor, Department of Infectious Diseases

俄罗斯联邦, St. Petersburg; St. Petersburg

Aleksandr Palchik

St. Petersburg State Pediatric Medical University, Ministry of Health of the Russia

Email: xander57@mail.ru
ORCID iD: 0000-0001-9073-1445

MD, Professor, Department of Neonatology with Courses in Neurology and Obstetrics and Gynecology, Faculty of Postgraduate Education and Additional Professional Education

俄罗斯联邦, St. Petersburg

Maria Fomina

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia; St. Petersburg State Pediatric Medical University, Ministry of Health of the Russia

Email: myfomina@mail.ru
ORCID iD: 0009-0002-0537-0660

MD, Professor, Department of Neonatology with Courses in Neurology and Obstetrics and Gynecology, Faculty of Postgraduate Education and Additional Professional Education, Neurologist

俄罗斯联邦, St. Petersburg; St. Petersburg

Galina Komarova

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia

Email: ochkas.galina@yandex.ru
ORCID iD: 0000-0001-6699-7374

Neurologist

俄罗斯联邦, St. Petersburg

Ilya Pereskokov

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia

Email: 9r1zv0ld@gmail.com
ORCID iD: 0009-0000-7079-9776

Functional Diagnostics Specialist

俄罗斯联邦, St. Petersburg

Evgeny Voronin

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia; I.I. Mechnikov North-West State Medical University, Ministry of Health of the Russia

Email: evevvoronin@gmail.com
ORCID iD: 0000-0001-7547-6407

MD, Chief Pediatric HIV Specialist of the Ministry of Health of the Russia, Head, Department of Scientific and Methodological Work and Medical and Social Assistance, Professor, Department of Infectious Diseases

俄罗斯联邦, St. Petersburg; St. Petersburg

Vladimir Rosenberg

Republican Clinical Infectious Diseases Hospital – Scientific and Practical Center for Prevention and Treatment of HIV Infection in Pregnant Women and Children, Ministry of Health of the Russia

Email: rovlad@inbox.ru
ORCID iD: 0000-0002-4966-9691

Cand. Med. Sci., Chief Physician

俄罗斯联邦, St. Petersburg

参考

  1. Williams M.E., van Rensburg A.J., Loots D.T., Naudé P.J.W., Mason S. Immune Dysregulation Is Associated with Neurodevelopment and Neurocognitive Performance in HIV Pediatric Populations-A Scoping Review. Viruses 2021; 13(12): 2543. doi: 10.3390/v13122543
  2. Green M.V., Raybuck J.D., Zhang X., Wu M.M., Thayer S.A. Scaling Synapses in the Presence of HIV. Neurochemical Research 2019; 44(1): 234–246. doi: 10.1007/s11064-018-2502-2
  3. Ru W., Tang S.-J. HIV-associated synaptic degeneration. Molecular Brain 2017; 10: 40. doi: 10.1186/s13041-017-0321-z
  4. Paul N.I., Okoh B.A.N., Alikor E.A.D. HIV Encephalopathy (HIVE) in Children at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria. International Journal of Clinical Medicine 2018; 9(6): 495–504. doi: 10.4236/ijcm.2018.96042
  5. Huff H.V., Sportiello K., Bearden D.R. Central Nervous System Complications of HIV in Children. Curr. HIV/AIDS Rep. 2024; 21(2): 40–51. doi: 10.1007/s11904-024-00689-x
  6. Horton R.H., Mcintosh A., Ostinelli E.G., Harriss E., Fazel M. Neuropsychiatric Outcomes in Children and Adolescents With Perinatally Acquired HIV: A Systematic Review and Meta-Analysis. J. Acquir. Immune Defic. Syndr. 2025; 98(5): 411–428. doi: 10.1097/QAI.0000000000003595
  7. Brahmbhatt H., Boivin M., Ssempijja V., Kagaayi J., Kigozi G., Serwadda D. et al. Impact of HIV and Atiretroviral Therapy on Neurocognitive Outcomes Among School-Aged Children. J. Acquir. Immune Defic. Syndr. 2017; 75(1): 1–8. doi: 10.1097/QAI.0000000000001305
  8. Coutifaris P., Byrd D., Childs J., Clark U., Posada R., Robbins R. et al. Neurobehavioral outcomes in young adults with perinatally acquired HIV. AIDS 2020; 34(14): 2081–2088. doi: 10.1097/QAD.0000000000002655(14)
  9. HIV/AIDS surveillance in Europe 2024: 2023 data. WHO. Copenhagen. ‎2024. 77 p.
  10. Hoare J., Stein D.J., Heany S.J., Fouche J.P., Phillips N., Er S. et al. Accelerated epigenetic aging in adolescents living with HIV is associated with altered development of brain structures. J. Neurovirol. 2022; 28(2): 208–216. doi: 10.1007/s13365-021-00947-3
  11. Rodriguez V.J., Alfonso D., van Landingham H., Kozlova S., Resch Z.J., Soble J.R. et al. Prevalence of neurodevelopmental delays in infants with perinatal HIV infection in comparison with HIV exposure in rural South Africa. AIDS 2023; 37(8): 1239–1245. doi: 10.1097/QAD.0000000000003553
  12. Fitting S., McLaurin K.A., Booze R.M., Mactutus C.F. Dose-dependent neurocognitive deficits following postnatal day 10 HIV-1 viral protein exposure: Relationship to hippocampal anatomy parameters. Int. J. Dev. Neurosci. 2018; 65: 66–82. doi: 10.1016/j.ijdevneu.2017.10.009
  13. Афонина Л.Ю., Слепцов А.И., Орлова А.А., Омельчук Д.В., Воронин Е.Е. ВИЧ-ассоциированные состояния у детей: актуальные вопросы в клинической практике. Материалы международной науч.-практ. конф. «Актуальные вопросы ВИЧ-инфекции. Охрана здоровья матери и ребенка». СПб.: Человек и его здоровье, 2021; 15–39. Afonina L.Yu., Sleptsov A.I., Orlova A.A., Omelchuk D.V., Voronin E.E. [HIV-associated conditions in children: current issues in clinical practice. Proceedings of the international scientific and practical conference «Current issues of HIV infection. Health protection of mother and child»]. St. Petersburg: Chelovek i ego zdorovie, 2021; 15–39. (In Russ.).
  14. Benki-Nugent S., Wamalwa D., Langat A., Tapia K., Adhiambo J., Chebet D. et al. Comparison of developmental milestone attainment in early treated HIV-infected infants versus HIV-unexposed infants: a prospective cohort study. BMC Pediatr. 2017; 17(1): 24. doi: 10.1186/s12887-017-0776-1
  15. Chahroudi A., Wagner T.A., Persaud D. CNS Persistence of HIV-1 in Children: the Untapped Reservoir. Curr. HIV/AIDS Rep. 2018; 15(5): 382–387. doi: 10.1007/s11904-018-0412-1
  16. O’Brien M. Aids to the examination of the peripheral nervous system: 6th edition. Pract. Neurol. 2023; 23(3): 263–264. doi: 10.1136/pn-2022-00368
  17. ВИЧ-инфекция у детей. Клинические рекомендации КР 459_2. Министерство здравоохранения РФ, 2024. [HIV infection in children. Clinical recommendation CR 459_2]. Ministry of Health of the Russian Federation, 2024. (In Russ.).
  18. Фоминых А.Я., Ржанова И.Е., Алексеева И.Е. Тест Векслера для дошкольников как метод диагностики интеллекта. Воспитание и обучение детей младшего возраста 2018; (7): 38–39. Fominykh A.Ya., Rzhanova I.E., Alekseeva O.S. [Wechsler test for preschoolers as a method of diagnosing intelligence]. Education and training of young children 2018; (7): 38–39. (In Russ.).
  19. Van Rie A., Harrington P.R., Dow A., Robertson K. Neurologic and Neurodevelopmental Manifestations of Pediatric HIV/AIDS: A Global Perspective. Eur. J. Paediatr. Neurol. 2007; 11(1): 1–9. doi: 10.1016/j.ejpn.2006.10.006
  20. Авилова В.А. Анализ причин нарушений речевого развития детей раннего возраста. Научный аспект 2020; 2(4): 197–205. Avilova V.A. [Analysis of the causes of speech development disorders in young children]. Scientific aspect 2020; 2(4): 197–205. (In Russ.).

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Distribution of examined children with HIV infection by age groups

下载 (46KB)
索引源数据
3. Fig. 2. Frequency of detection of general cerebral disorders

下载 (73KB)
索引源数据

版权所有 © Bionika Media, 2025