CENTRAL NERVOUS SYSTEM (CNS) INVOLVEMENT IN CHILDREN WITH HIV INFECTION CEREBRAL COMPUTED TOMOGRAPHY (CCT) FINDINGS.

Abstract

CNS is one of the target organs in children with HIV infection. The aims of this work were to correlate the clinical-neurologic signs with CCT findings in symptomatic HIV+children and to establish the predictive value of both parameters. Thirty eight patients infected with the human immunodeficiency virus and without specific treatment were evaluated (age range:4 months to 8 years). Six patients had no abnormal neurological signs. They were the negative control group and their CCT were normal. Out of 32 patients with signs of neurologic injury, 28(87%) had pathologic CCT. Twelve out of these 28 patients died (43%). The CCT findings were:(A) Cerebral atrophy (Cortical and/or central)=10/28 cases (35%);(B)Calcifica-tions of basal ganglia + (A)=5/28 cases (18%);(C) Low density of white matter=3/28 cases (11%);(D) Damage secondary to opportunistic infection=4/28 cases (14%) (Histoplasrrosis;Toxoplasmosis;Chagas Disease and Pneumococcal meningitis) and (E)Associated pathology findings=7/28 cases(25%) (Congenital infections;Congenital Hydrocephalus and Battered Child). The remaining four CCT=4/32 cases (13%)were normal and correponded to patients with Static Encephalopathy; they were 3 to 5 years old. We conclude that:a)The main CCT findings were cerebral atrophy and calcifications of basal ganglia; b)We did not find any primary CNS lymphoma;c)Neurological signs were found prior to CCT abnormalities;d)CCT pathologic findings were associated to poor diagnosis.