Measures of cognitive function and social-emotional behavior were correlated with CT abnormalities in 87 children with symptomatic human immunodeficiency virus type 1 disease (HIV) at the Pediatric Branch, National Cancer Institute, and the NIND & S, Bethesda, MD; Children’s National Medical Center, Washington, DC; and Medical Illness Counselling Center, Chevy Chase, MD. The mean age of the patients was 4.3 yrs. Vertically infected children were 2.3 +/- 0.3 years, and transfusion-infected children were 8.4 +/- 0.6 years of age. The Full Scale IQ (FIQ) was a mean of 85.2 for the total group; 80 for vertically infected; and 95.5 for transfusion-infected patients. A significant correlation was found between FIQ and the overall CT severity rating. The correlation was stronger in (younger) vertically infected compared with older transfusion-infected children. Calcifications, observed only in vertically infected children (16 of 58), were associated with greater delays in neurocognitive development, independent of the degree of brain atrophy. [1]

COMMENT. CT scans are recommended as a baseline for patients at risk for CNS manifestations and cognitive deficits due to HIV. Even when mild, CT abnormalities were of clinical significance.

The above authors have studied the effects of HIV disease on receptive and expressive language in 36 children with symptomatic HIV and the relation to CT scan brain abnormalities [2]. Expressive language was more impaired than receptive language. Greater severity of CT abnormalities was correlated with poorer receptive and expressive language functioning. The language impairments were associated with the direct effects of HIV-related CNS disease.

A speech motor control disorder developed after HIV infection in 6 right-handed patients. They had an ataxic dysarthria, associated with ataxic gait and intention tremors. The motor speech disorder was due to a cerebellar dysfunction. [3]