Correlation Between Computed Tomographic Brain Scan Abnormalities and Neuropsychological Function in Children With Symptomatic Human Immunodeficiency Virus Disease

Objective: To evaluate the clinical significance of computed tomographic brain scan abnormalities observed in children with symptomatic human immunodeficiency virus disease. Patients: Eighty-seven previously untreated children with symptomatic human immunodeficiency virus type 1 disease. Methods: General levels of cognitive functioning, obtained from age-appropriate intelligence tests, and socialemotional behavior were correlated with computed tomographic brain scan abnormality ratings. Results: A significant relation between computed tomographic brain scan abnormalities and cognitive dysfunction as well as aberrant behavior was found, which appeared stronger in (younger) vertically infected children compared with transfusion-infected patients. Calcifications, independent from the degree of brain atrophy, were associated with significantly greater delays in neurocognitive development. Conclusion: Computed tomographic brain scan abnormalities, even when mild, were of clinical significance, suggesting that human immunodeficiency virus—associated central nervous system compromise is a continuous process and that scans may be helpful at baseline in defining patients at risk and for monitoring them during therapy.