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Title: Neurologic manifestations of childhood AIDS in Benin City, Nigeria
Issue Date: 2007
Publisher: Journal of Paediatric Neurology
Series/Report no.: 5;21-25
Abstract: Introduction: The human immunodeficiency virus (HIV) infection is a multi-systemic illness and often leads to AIDS in untreated cases. In children, neurologic manifestations are common. HIV encephalopathy is a neurological dysfunction arising from direct HIV infection of the brain. It ranges between 30-50% in untreated cases and 5-10% in those on Highly Active Anti-retroviral Therapy (HAART). There is a paucity of information on neurological manifestations of HIV/AIDS in children from sub-Sahara Africa. Subjects and Methods: We reviewed the records of all consecutive HIV infected non-neonatal children presenting to the paediatric department of the University of Benin Teaching Hospital, Benin City, Nigeria, between January 1999 and December 2004. Those who had neurologic manifestations were included in the study. Their biodata, the results of cerebrospinal fluid analysis, mantoux tests and AAFB determination were obtained. The HIV sero-status was determined using ELISA test and confirmed by western blot. In children less than 18months, the CDC criteria for surveillance case definition for AIDS was used. HIV encephalopathy was diagnosed based on CDC revised classification criteria. Results: Of the 203 HIV seropositive children, 15(7.4%) had neurologic manifestations, the most common manifestations are brisk deep tendon reflexes 14(93.3%), extensor plantar responses 10(66.7%) and cortical fisting 8(53.3%). The M:F ratio was 1:2; mean age was 7.7 ± 4.8 (range, 3-18) months. As a result of cost, five (33.3%) patients had their CD4+ count determined on presentation and ranged between 30 and 300 per microlitre. Of the15 patients, 12(80.0%) died, 8 while in hospital and 4 at follow-up visit. Three patients were lost to follow-up. Five patients received HAART for a mean (range) of 11.3 ± 2.5 (7-14) weeks. Conclusion: Children with HIV/AIDS present with severe neu rologic manifestations and often delay in seeking appropriate medical care. It is envisioned that the promotion of the ‘Prevention of Mother To Child Transmission’ programme coupled with early therapy with HAART, will prevent the high mortality currently associated with this condition.
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