Article

SIDA
An estimated 3.2 million children worldwide have human immunodeficiency virus
(HIV) infection. Antiretroviral therapy (ART) has resulted in prolonged survival,
leading to an increase in complications previously recognized in adults. Children
with HIV infection have increased risk of cerebrovascular disease from multiple
aetiologies including HIV-associated vasculopathy, opportunistic vasculitis,
cardioembolism or coagulopathy, all of which may be secondary to the infection.
Prevalence of cerebrovascular disease in HIV-infected children is underestimated
because of limited neuroimaging in low and middle income countries, silent events
without overt motor manifestations, and mislabeling as HIV encephalopathy for
non-motor manifestations such as behavioural and cognitive difficulties. No
management guidelines for cerebrovascular disease in HIV-infected children exist
but common practices target risk factors for stroke in low and middle income
countries. Where capacity permits, screening for opportunistic infections,
vasculitis, coagulopathy and cardioembolism is important. Optimising virological
suppression, correction of anaemia, control of seizures and aspirin prophylaxis
are management priorities. Neurosurgical interventions may have a role.
CI - (c) 2016 Mac Keith Press.

Langue : ANGLAIS