Diagnostic markers in the aspect of the development of HIV-encephalopathy in children
https://doi.org/10.22625/2072-6732-2021-13-3-55-61
Abstract
The aim of the study was to evaluate the diagnostic markers in children with HIV —encephalopathy (HIVE) with varying degrees of severity.
Material and methods of research: The study included 260 children (153 boys — 58.85% and 107 girls —41.7%) with HIV-positive status and receiving antiretroviral therapy according to an individually selected scheme for at least 6 months. All children included in the study showed signs of HIV encephalopathy. The activity response was assessed by the concentration of IL-6, IL-10, TNF-alpha, C-reactive protein, C3, C4 components of the complement (immunofelometric analysis).
Results: The study of the activity response in children with HIV encephalopathy found that the concentration of TNF —alpha and IL-6 were increased, compared, to the reference values (12.67±0.25 PG/ml and 23.04±0.64 PG/ml, respectively, with reference values of less than 8.1 PG/ml and 7pg/ml, respectively), and the concentration of IL-10 was reduced (5.93±0.10 PG/ml with a reference value of more than 9.1 PG/ml). The study analyzed the predictor significance of various parameters response in the aspect of the development of symptomatic HIV- encephalopathy. A comparative analysis of the concentration markers was performed, and the incidence of symptomatic HIV —encephalopathy was determined depending on the diagnostic concentration of the diagnostic marker. This finding is probably explained by the effector role of systemic inflammation in the development of damage to the Central nervous system.
Conclusion. The maximum predictor significance in the aspect of the development of symptomatic HIV -encephalopathy was found in proinflammatory cytokines: an increase in IL-6 concentration above 19.6 PG / ml is associated with an increase in the risk of developing symptomatic HIV encephalopathy by 9.14 times, and an increase in TNF -alpha concentration above 12.5 PG/ml by 4.07 times (p<0.001 for both factors).
About the Authors
S. N. SaidkhodjaevaUzbekistan
Tashkent.
Competing Interests:
No
E. N. Madjidova
Uzbekistan
Tashkent.
Competing Interests:
No
K. Kh. Yuldashev
Uzbekistan
Tashkent.
Competing Interests:
No
References
1. UNAIDS. Global AIDS Update. Geneva: Joint United Nations Programme on HIV/AIDS; 2016. Global AIDS Update 2016.
2. UNAIDS. UNAIDS, ed Global AIDS Update. Geneva: Joint United Nations Programme on HIV/AIDS; 2017. UNAIDS Data 2017
3. Foster CJ, Biggs RL, Melvin D, et al: Neurodevelopmental outcomes in children with HIV infection under 3 years of age. Dev Med Child Neurol 48:677-682, 2006
4. Chiriboga CA, Fleishman S, Champion S, et al: Incidence and prevalence of HIV encephalopathy in children with HIV infection receiving highly active anti-retroviral therapy (HAART). J Pediatr 146:402-407, 2005
5. Nachman SA, Chernoff M, Gona P, et al: Incidence of noninfectious conditions in perinatally HIV-infected children and adolescents in the HAART era. Arch Pediatr Adolesc Med 163:164-171. http://dx.doi.org/10.1001/archpedi.163.2.164. [Erratum in: Arch Pediatr Adolesc Med. 2009 Apr;163(4):364]
6. Patel K, Ming X, Williams PL, et al: Impact of HAART and CNS-penetrating antiretroviral regimens on HIV encephalopathy among perinatally infected children and adolescents. AIDS 23:1893-1894-1901, 2009
7. Shanbhag MC, Rutstein RM, Zaoutis T, et al: Neurocognitive functioning in pediatric human immunodeficiency virus infection: Effects of combined therapy. Arch Pediatr Adolesc Med 159:651-656, 2005
8. Laughton B, Cornell M, Grove D, et al: Early antiretroviral therapy improves neurodevelopmental outcomes in infants. AIDS 26:1685, 2012
9. Puthanakit T, Ananworanich J, Vonthanak S, et al: Cognitive function and neurodevelopmental outcomes in HIV-infected Children older than 1 year of age randomized to early versus deferred antiretroviral therapy: The PREDICT neurodevelopmental study. Pediatr Infect Dis J 32:501-508. http://dx.doi.org/10.1097/INF.0b013e31827fb19d.
10. Smith L, Adnams C, Eley B: Neurological and neurocognitive function of HIV-infected children on antiretroviral therapy. S Afr J Child Health 2:108-118, 2008
11. Whitehead N, Potterton J, Coovadia A: The neurodevelopment of HIV-infected infants on HAART compared to HIV-exposed but uninfected infants. AIDS Care 26:497-504, 2013
12. Wood SM, Shah SS, Steenhoff AP, et al: The impact of AIDS diagnoses on long-term neurocognitive and psychiatric outcomes of surviving adolescents with perinatally acquired HIV. AIDS 23:1859-1865. http://dx.doi.org/10.1097/QAD.0b013e32832d924f.
13. Campbell T: A review of the psychological effects of vertically acquired HIV infection in infants and children. Br J Health Psychol 2:1-13, 2011
14. Govender R, Eley B, Walker K, et al: Neurologic and neurobehavioral sequelae in children with human immunodeficiency virus (HIV-1) infection. J Child Neurol 26:1355-1364, 2011
15. Willen EJ: Neurocognitive outcomes in pediatric HIV. Ment Retard Dev Disabil Res Rev 12:223-228, 2006
16. Pearson DA, McGrath NM, Nozyce M, et al: Predicting HIV disease progression in children using measures of neuropsychological and neurological functioning. Pediatric AIDS clinical trials 152 study team. Pediatrics 106:E76, 2000
17. CDC1994 revised classification system for HIV infection in children less than 13 years of age. MMWR Recomm Rep 443:1-10, 1994
18. Walker SP, Wachs TD, Grantham-McGregor S, et al: Inequality in early childhood: Risk and protective factors for early child development. Lancet 378:1325-1338, 2011
19. Langerak NG, du Toit J, Burger M, et al: Spastic diplegia in children with HIV encephalopathy: First description of gait and physical status. Dev Med Child Neurol http://dx.doi.org/10.1111/dmcn.12319. [Epub ahead of print].
20. Le Doare K, Bland R, Newell M: Neurodevelopment in children born to HIV-infected mothers by infection and treatment status. Pediatrics 130: e1326-e1344, 2012
21. Abubakar A, Van Baar A, Van de Vijver FJ, et al: Paediatric HIV and neurodevelopment in sub-Saharan Africa: A systematic review. Trop Med Int Health 13:880-887, 2008
22. Van Rie A, Mupuala A, Dow A: Impact of the HIV/AIDS epidemic on the neurodevelopment of preschool-aged children in Kinshasa, Dem-ocratic Republic of the Congo. Pediatrics 122:e123-e128, 2008
23. Bloch M, Kamminga J, Jayewardene A, et al. : A Screening Strategy for HIV-Associated Neurocognitive Disorders That Accurately Identifies Patients Requiring Neurological Review. Clin Infect Dis. 2016;63(5):687-693. http://dx.doi.org/10.1093/cid/ciw399 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
24. Dahl V, Peterson J, Fuchs D, et al. : Low levels of HIV-1 RNA detected in the cerebrospinal fluid after up to 10 years of suppressive therapy are associated with local immune activation. AIDS. 2014;28(15):2251-2258. http://dx.doi.org/10.1097/QAD.0000000000000400 [PMC free article] [PubMed] [Cross-Ref] [Google Scholar]
Review
For citations:
Saidkhodjaeva S.N., Madjidova E.N., Yuldashev K.Kh. Diagnostic markers in the aspect of the development of HIV-encephalopathy in children. Journal Infectology. 2021;13(3):55-61. (In Russ.) https://doi.org/10.22625/2072-6732-2021-13-3-55-61