Neurologic disorders in HIV-positive orphans: 10 years of follow up.

OBJECTIVE: Neuropsychic manifestations of AIDS are still noticeable especially in developing countries. The aim of this short communication is to describe psychological, behavioral and neurologic disorders caused by either HIV-related disorders, or drug related toxicities in HIV-infected children from Cambodia (Phnom Penh, Sihanoukville) treated during 10 years with highly active antiretroviral therapy (HAART).

METHODS: One hundred and thirty seven (137) HIV-positive children (age 2-19 years) treated with HAART since 2003 (6-10 years follow up) have been analyzed concerning opportunistic infections, other co-infections, renal parameters, hematologic parameters, chest X-ray, antiretroviral treatment, anti-tuberculotics and antibiotics treatment. We recorded prospectively all data since the start of HAART from 2003-2005 up to December 2012.

RESULTS: Occurrence of drug related neuritis due to stavudine (HAART) was less than 1% and was associated with anti-tuberculous agents accompanying HAART in HIV- and tuberculosis co-infected patients. Co-infections with neurotropic viruses were more frequent: 1 case of CMV retinitis, 18 cases of herpes zoster neuritis and 37 cases of generalized HZV infections (varicella), after onset HAART in children were recorded. All children responded well to anti-viral therapy with ganciclovir (CMV), vanciclovir or acyclovir (HZV) in combination with first line HAART.

CONCLUSION: Neurologic disorders in children with HAART are less frequent than in adults. Anti-retrovirals and anti-tuberculosis drugs seem to be safe and less toxic in children then in adults. Co-infections with neurotropic viruses were more frequent, however, were successfully treated with anti-virals.