Neurobehavioral and Neurodevelopmental Sequelae Associated with Pediatric HIV Infection

Neurodevelopmental and neurobehavioral manifestations in infancy and childhood, resulting from Human Immunodeficiency Virus-Type 1 (HIV-1) infection, continue to warrant special and distinct consideration in this handbook. As noted in our chapter in the previous edition of this volume (Llorente, LoPresti, & Satz, 1997), this merit partly stems from the unique impact of this disease process on the rapidly maturing Central Nervous System (CNS) of the child (Belman, 2002; Epstein et al., 1985, 1986; Falloon, Eddy, Wiener, & Pizzo, 1989; Lyman et al., 1990; Pizzo & Wilfert, 1994, 1998) in conjunction with the scientific purviewof developmental neuropsychology and neuroscience, the study of brain–behavior relationships (Lezak, Howison, & Loring, 2005). However, aside from these developmental and scientific reasons, duly attention also stems from several other factors including clinical, epidemiological, and humanistic factors requiring dedicated space in this volume and the expenditure of significant amounts of societal economic and intellectual resources. In this regard, HIV has reached pandemic proportions in selected areas around the globe, the virus has been unequivocally implicated in Acquired Immunodeficiency Syndrome (AIDS), and more specifically related to this volume, HIV infection has been shown to be associated with significant cognitive and behavioral effects during the developmental period (Boivin et al., 1995; Brouwers, Belman, E Brouwers, Moss, Wolters, & Schmitt 1994,; Chase et al., 2000; Drotar et al., 1997; Hittleman et al., 1991; Llorente et al., 1997, 2000, 2001, 2003, 2006; Llorente, Turcich, & Lawrence, 2004; Mellins et al., 2003; Pizzo & Wilfert, 1994), findings which have become increasingly documented in the literature since the last edition. Finally, the impact of HIV-1 infection on the developing brain has been the focus of significant attention by the neuroscientific community and has become one of the main health-related concerns of our generation in the United States and abroad. Although not applicable to countries where treatments are readily available such as United States, it remains true today, as noted in 1997 (Llorente et al., 1997), mortality resulting from pediatric HIV infection and AIDS continues to experience a sharp and dramatic increase in selected parts of the world, despite decreases in other areas around the globe (WHO, 2005). This continued rise in the number of infected cases and deaths, whether the result of enhanced surveillance techniques, ANTOLINM. LLORENTE Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD 21209. CHRISTINE LOPRESTI, AND PAUL SATZ Department of Psychiatry and Biobehavioral Sciences, University of California School of Medicine, Neuropsychiatric Institute andHospital, Los Angeles, CA 90024.