The authors describe the main epidemiological, pathogenetic and clinical features of HIV-related encephalopathy in 50 pediatric patients (36 females, 24 males), born to HIV-seropositive mothers or infected by contaminated blood, observed in the Institute of Infectious Diseases of Pavia, bewenn January 1984 and December 1994. All the paatients (age 1 day-7 years) received a Comprehensive evaluation, including subsequent neurodevelopmental assessments, by a multidisciplinary equipe of pediatric infectivologists and neuro-psychiatrists: the follow-up ranges from 6 months to 8.5 years. To evaluate ther ole of potentially covariates in HIV-vertically infected children, some maternal, gestational and perinatal factors were investigated. The neurodevelopmental assessment was carried out by a standardized protocol: tests were Always conducted and evaluated by the same examiner. Seventeen pediatric patients with HIV-related neurologic impairment were observed (3%): 16 cases of encephalpathy (static-stable = 4, plateau = 6, subacute-progressive = 5, uncerain origin = 1) and 1 case of neurotoxoplasmosis. Findings of the current study demonstrate the high frequency of neurological impairment in HIV-infected infant/child, a worse evolution in this kind of patients and the effectiveness of an antiretroviral therapy only if administrated in the early phases of the disease. It was also emphasized the pathogenetic role of some covariates poorly evaluated in previously reported studies.
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