Abstract
BackgroundThis short report arose from a follow-up study of children previously diagnosed with human immunodeficiency virus (HIV) encephalopathy and spastic diplegia and is among the first to describe that increased lower limb muscle tone in children with a confirmed HIV encephalopathy diagnosis may resolve over time in some cases.ResultsOf 19 children previously diagnosed with HIV encephalopathy and increased lower limb muscle tone, some were found to have resolved muscle tone abnormalities during a follow-up physical examination [resolved group, n = 13, median age 9 years 7 months (interquartile range 7 years 3 months–10 years 9 months)] whereas others continued to show increased lower limb muscle tone at follow-up [unresolved group, n = 6 median age 8 years 6 months (interquartile range 7 years 9 months–9 years 7 months)]. A review of clinical records showed no significant differences in age or follow-up time between the resolved and unresolved groups. However, the unresolved group appeared to have severe disease at an earlier age than the resolved group, based on the age at antiretroviral treatment initiation [median age at start of treatment 2 years 3 months (interquartile range 7 months–5 years 3 months) vs. 8 months (interquartile range 6–12 months), p = 0.08] and had more severe neurological signs at the initial assessment.ConclusionsIt is anticipated that this information may be of immediate value to those involved in the treatment of children with HIV encephalopathy and increased lower limb muscle tone whilst awaiting the outcome of future controlled clinical trials.
Highlights
This short report arose from a follow-up study of children previously diagnosed with human immunodeficiency virus (HIV) encephalopathy and spastic diplegia and is among the first to describe that increased lower limb muscle tone in children with a confirmed HIV encephalopathy diagnosis may resolve over time in some cases
It is anticipated that this information may be of immediate value to those involved in the treatment of children with HIV encephalopathy (HIVE) and increased lower limb muscle tone whilst awaiting the outcome of future controlled clinical trials
Thirteen of the 19 children previously recorded with spastic diplegia or increased muscle tone in the lower limbs no longer showed any evidence of these signs whereas the remaining six children continued to show increased muscle tone in the lower limbs
Summary
This short report arose from a follow-up study of children previously diagnosed with human immunodeficiency virus (HIV) encephalopathy and spastic diplegia and is among the first to describe that increased lower limb muscle tone in children with a confirmed HIV encephalopathy diagnosis may resolve over time in some cases. This topic was not the aim of our planned research study We felt it important to report our clinical observations and offer preliminary insights into the possible role of (1) the current age of the children and follow-up time; (2) the severity of the initial neurological findings and; (3) age at the start of antiretroviral therapy (ART) on the subsequent resolution of increased lower limb muscle tone. It is anticipated that this information may be of immediate value to those involved in the treatment of children with HIVE and increased lower limb muscle tone whilst awaiting the outcome of future controlled clinical trials
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