ENCEPHALOPATHY IN CHILDREN WITH PERINATALLY ACQUIRED HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Objective: To define the incidence, characteristics, and survival of c hildren with perinatally acquired human immunodeficiency virus (HIV) i nfection and encephalopathy. Design: Cross-sectional and longitudinal data collected from 1811 HIV-infected children in a multicenter active surveillance study. Setting: Health departments and medical centers i n six areas of the United States. Results: HIV encephalopathy was diag nosed in 178 (23%) of 766 children with perinatally acquired immunodef iciency syndrome (AIDS), The median age at diagnosis of encephalopathy was 19 months, Among infected children, the estimated risk of having HIV encephalopathy by age 12 months was 4.0% (95% confidence interval, 2.6% to 6.0%), Children with HIV encephalopathy had more hospitalizat ions (median, 4) than children with other AIDS-defining conditions (me dian, 2; p = 0.002) and lower CD4(+) T-lymphocyte counts in the first year of life (median, 444 cells/mm(3)), Estimated median survival afte r diagnosis was 22 months, similar to the 20 months for children with Pneumocystis carinii pneumonia. Conclusion: HIV encephalopathy in chid ren with perinatally acquired AIDS is a common condition and is associ ated with severe morbidity evidenced by frequent hospitalizations, sev ere immunodeficiency, and short survival.