Background: The Human Immune Deficiency Virus (HIV) can manifest neurologically in both adults and children. Early\ninvasion of the central nervous system by the virus, affecting the developing brain, is believed to result in the most\ncommon primary HIV-related neurological complication, HIV Encephalopathy (HIVE). In countries such as South Africa\nwhere many children have not been initiated on antiretroviral treatment early, HIVE remains a significant clinical problem.\nMethods: Children were selected from a clinic for children with neurologic complications of HIV, located at the Red Cross\nWar Memorial Childrenââ?¬â?¢s Hospital, South Africa 2008ââ?¬â??2012. Eligible subjects fulfilled the following inclusion criteria: aged 6\nmonths-13 years; positive diagnosis of HIV infection, vertically infected and HIVE as defined by CDC criteria. Each\nparticipant was prospectively assessed by a Pediatric Neurologist using a standardized proforma which collated relevant\ndetails of background, clinical and immunological status.\nResults: The median age of the 87 children was 64 months (interquartile range 27ââ?¬â??95 months). All except one child\nwere on anti retroviral treatment, 45% had commenced treatment <12 months of age. Delayed early motor milestones\nwere reported in 80% and delayed early speech in 75% of children in whom we had the information. Twenty percent\nhad a history of one or more seizures and 41% had a history of behavior problems. Forty-eight percent had microcephaly\nand 63% a spastic diplegia. CD4 percentages followed a normal distribution with mean of 30.3% (SD 8.69). Viral loads\nwere undetectable (
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