n South African Medical Journal - Orphans, HIVE and HAND : who are the watch-keepers? : editorial

Volume 104, Issue 10
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



Since 2004, substantial numbers of South African (SA) children have benefited from antiretroviral treatment. Untreated children are at risk of central nervous system (CNS) sequelae, with prevalence rates of 20 - 60%. HIV-1 invades the developing CNS earlier and with greater severity than in adults, resulting in the condition known as HIV encephalopathy (HIVE). In addition, patients on highly active antiretroviral therapy (HAART) may remain vulnerable to the effects of HIV on the brain, because the CNS may be a reservoir for persistent viral replication. The concept of a 'milder' form of neurocognitive disturbance in HIV-infected children, akin to the adult condition of HAND (HIV-associated neurocognitive disorder), is recognised but has yet to be defined.

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