NEUROLOGICAL CHANGES IN SEROREVERTERS AT MULAGO HOSPITAL IN UGANDA

Kalyesubula¹ Israel, Nassali¹ Annette, Sherman² Becky, Bakaki¹ Paul, Olness³ Karen

1 Makerere University, 2 Visitor Makerere University, 3 CWRU-Ohio

Objective: To assess progress of HIV seroreverter children who had been followed eight to ten years earlier in a study of neurodevelopment of HIV exposed infants in Uganda.

Background: A neurodevelopment study in children born to HIV-1 infected women and negative controls was undertaken in a Mother-Child Clinic at Old Mulago between 1990 and 1994. The children's neurologic development, including a full central nervous system, speech, motor development, was assessed by paediatricians every three months and recorded for a two year follow up period. Children who did not vertically acquire HIV-1 infection (seroreverters) were traced by a clinic social worker and those who were readily available were brought to the clinic. After the parents\gaurdians had consented to this study, the children’s neurodevelopment was assessed as previously by one of the same paediatricians who had followed them eight to ten years earlier. The findings were compared with those noted at the time of completion of the initial study.

Results: The first forty-five children to be found were examined. Five were excluded from the analysis because their previous records could not be readily located. Nine of 20 children who had had abnormal neurologic findings at two years of age were among these forty analysed. Previously five had hyperreflexia reported in all limbs and four had both hyperreflexia and hypotonia. All reported forty analysed children, including the nine with abnormal findings at two years, had normal neurologic findings.

Conclusion: Ugandan children who were HIV seroreverters showed no evidence of persistent neurologic abnormalities nor did they develop new abnormalities on neurologic examination as they matured.

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