INTERRELATIONS AMONG PATTERNS OF CHANGE IN NEUROCOGNITIVE, CT BRAIN IMAGING AND CD4 MEASURES ASSOCIATED WITH ANTIRETROVIRAL THERAPY IN CHILDREN WITH SYMPTOMATIC HIV-INFECTION

The interrelationships of patterns of change and variability between b aseline and after 6 months of anti-retroviral therapy in neurocognitiv e, brain imaging, and immune measures were studied in 77 children with symptomatic HIV disease. Overall improvement in CNS structure/functio n after 6 months of anti-retroviral therapy was limited; new intracere bral calcifications tended to occur and old ones tended to progress in young children with vertically acquired HIV infection, despite treatm ent. Substantial inter-individual differences in change were however o bserved. Factors which explained part of the variance in the magnitude and direction of change were baseline structural and functional abnor malities, rating of degree of CNS penetration of the drug protocol, an d concurrent changes on other variables. These preliminary data sugges t that CNS specific effects of therapies as well as pretreatment statu s of CNS function/structure need to be taken into consideration when e valuating future trials of anti-retroviral therapy for children with s ymptomatic HIV infection.