Features of nervous system damage in children with HIV infection

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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.

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Sobre autores

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

Autor responsável pela correspondência
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

Rússia, 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

Rússia, 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

Rússia, 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

Rússia, 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

Rússia, 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

Rússia, 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

Rússia, 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

Rússia, St. Petersburg

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2. Fig. 1. Distribution of examined children with HIV infection by age groups

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3. Fig. 2. Frequency of detection of general cerebral disorders

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