Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease

P. Brouwers, G. Tudor-Williams, Charles DeCarli, H. A. Moss, P. L. Wolters, L. A. Civitello, P. A. Pizzo

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objective: To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests. Design: Consecutive case series. Setting: Government medical research center. Patients: Eighty-six previously untreated children with symptomatic HIV-1 disease. Results: CD4% measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4% measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01). Conclusions: Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.

Original languageEnglish (US)
Pages (from-to)713-720
Number of pages8
JournalAIDS
Volume9
Issue number7
StatePublished - 1995
Externally publishedYes

Fingerprint

Tomography
HIV
Brain
Nervous System Malformations
HIV-1
Central Nervous System
Atrophy
HIV Core Protein p24
HIV Antigens
Antigens
Cognition
HIV Infections
Disease Progression
Biomedical Research
Leukocytes
Lymphocytes
Serum

Keywords

  • CD4+ lymphocytes
  • Central nervous system disease
  • Computed tomography brain scan
  • HIV encephalopathy
  • Neuropsychological tests
  • p24 antigen
  • Pediatric AIDS

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

Cite this

Brouwers, P., Tudor-Williams, G., DeCarli, C., Moss, H. A., Wolters, P. L., Civitello, L. A., & Pizzo, P. A. (1995). Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease. AIDS, 9(7), 713-720.

Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease. / Brouwers, P.; Tudor-Williams, G.; DeCarli, Charles; Moss, H. A.; Wolters, P. L.; Civitello, L. A.; Pizzo, P. A.

In: AIDS, Vol. 9, No. 7, 1995, p. 713-720.

Research output: Contribution to journalArticle

Brouwers, P, Tudor-Williams, G, DeCarli, C, Moss, HA, Wolters, PL, Civitello, LA & Pizzo, PA 1995, 'Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease', AIDS, vol. 9, no. 7, pp. 713-720.
Brouwers P, Tudor-Williams G, DeCarli C, Moss HA, Wolters PL, Civitello LA et al. Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease. AIDS. 1995;9(7):713-720.
Brouwers, P. ; Tudor-Williams, G. ; DeCarli, Charles ; Moss, H. A. ; Wolters, P. L. ; Civitello, L. A. ; Pizzo, P. A. / Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease. In: AIDS. 1995 ; Vol. 9, No. 7. pp. 713-720.
@article{6beff213ff574b69a98a7101f26a2b8c,
title = "Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease",
abstract = "Objective: To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests. Design: Consecutive case series. Setting: Government medical research center. Patients: Eighty-six previously untreated children with symptomatic HIV-1 disease. Results: CD4{\%} measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4{\%} measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01). Conclusions: Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.",
keywords = "CD4+ lymphocytes, Central nervous system disease, Computed tomography brain scan, HIV encephalopathy, Neuropsychological tests, p24 antigen, Pediatric AIDS",
author = "P. Brouwers and G. Tudor-Williams and Charles DeCarli and Moss, {H. A.} and Wolters, {P. L.} and Civitello, {L. A.} and Pizzo, {P. A.}",
year = "1995",
language = "English (US)",
volume = "9",
pages = "713--720",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease

AU - Brouwers, P.

AU - Tudor-Williams, G.

AU - DeCarli, Charles

AU - Moss, H. A.

AU - Wolters, P. L.

AU - Civitello, L. A.

AU - Pizzo, P. A.

PY - 1995

Y1 - 1995

N2 - Objective: To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests. Design: Consecutive case series. Setting: Government medical research center. Patients: Eighty-six previously untreated children with symptomatic HIV-1 disease. Results: CD4% measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4% measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01). Conclusions: Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.

AB - Objective: To study the relationships between stage of HIV disease, reflected by CD4+ lymphocyte percentages and p24 antigen levels, and HIV-associated central nervous system (CNS) abnormalities, measured by computed tomography (CT) brain-scan ratings and neurobehavioral tests. Design: Consecutive case series. Setting: Government medical research center. Patients: Eighty-six previously untreated children with symptomatic HIV-1 disease. Results: CD4% measures correlated significantly with overall CT brain-scan severity ratings (r = -0.45; P < 0.001) as well as with its component parts (cortical atrophy, white matter abnormalities, and intracerebral calcifications); they were of comparable magnitude for vertically and transfusion-infected children. CD4% measures were also associated with the general level of cognitive function (r = 0.32; P < 0.005). Furthermore, patients with detectable serum p24 antigen levels (n = 39) had CT brain scans that were more abnormal than patients with undetectable p24 levels (n = 20; CT abnormality ratings of 21.3 versus 35.9; P < 0.02); similar differences were found for the cortical atrophy and calcification ratings. p24 levels also correlated with the overall CT brain-scan severity rating (r = 0.34; P < 0.01). Conclusions: Degree of CT brain-scan abnormality and level of cognitive dysfunction were significantly associated with the stage of HIV-1 disease, as reflected by either CD4 leukocyte measures or elevations of p24 antigen. The relation between the CT brain-scan lesions and markers of HIV disease (both CD4 and p24) suggest that these CNS abnormalities are most likely associated with HIV-1 infection, and further support the hypothesis that the interaction between systemic disease progression and CNS manifestations is continuous rather than discrete.

KW - CD4+ lymphocytes

KW - Central nervous system disease

KW - Computed tomography brain scan

KW - HIV encephalopathy

KW - Neuropsychological tests

KW - p24 antigen

KW - Pediatric AIDS

UR - http://www.scopus.com/inward/record.url?scp=0029009908&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029009908&partnerID=8YFLogxK

M3 - Article

C2 - 7546416

AN - SCOPUS:0029009908

VL - 9

SP - 713

EP - 720

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 7

ER -