Abstract
One of the most serious consequences of vertical HIV-infection is its impact on the central nervous system (CNS). Although much work has been done to elucidate the complex mechanism of HIV associated neurotoxicity, several questions remain unanswered. The purpose of this review is to summarise what is already known in the field of neuroimaging in vertically acquired HIV, addressing three aims and to highlight possible future directions in using neuroimaging and neurocognitive testing to understand the spectrum of neurocognitive disorders in HIV positve children. Here we aim to address several clinically relevant questions in pediatric neuroHIV, using the current evidence base by conducting a systematic review. We aim to investigate what is known about the relationship between cognitive impairment and central nervous system damage in HIV as seen in neuroimaging studies, and to search for any evidence in the current literature which suggests a spectrum of neuocognitive disorders in vertically infected HIV. Secondly, we aim to enquire whether children with a clinical diagnosis of encephalopathy are clearly distinguishable from HIV positive children without encephalopathy on neuroimaging and neurocognitive testing. Finally aim to investigate what is known about the effect on the CNS of antiretroviral therapy in paediatric HIV. Three separate databases were searched and two investigators systematically evaluated the titles, abstracts, and keywords associated with each individual article to determine those that may have met the inclusion and exclusion criteria. Following this process 11 studies were included in the review. Thus there was limited available data to address the 3 questions posed.
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Acknowledgments
JH-has received support from the Biological Psychiatry special interest group of the South Africa Society of Psychiatrists, National Research Foundation (NRF) and the Discovery Foundation Academic Award of South Africa.
DS- has received support from the National Research Foundation (NRF), the Biological Psychiatry special interest group of the South Africa Society of Psychiatrists, the Medical Research Foundation of South Africa (MRC) and the Faculty of Health Sciences Research Committee, University of Cape Town.
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The authors declare that they have no conflict of interest.
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Hoare, J., Ransford, G.L., Phillips, N. et al. Systematic review of neuroimaging studies in vertically transmitted HIV positive children and adolescents. Metab Brain Dis 29, 221–229 (2014). https://doi.org/10.1007/s11011-013-9456-5
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DOI: https://doi.org/10.1007/s11011-013-9456-5