Abstract 970 Poster Session IV, Tuesday, 5/4 (poster 108)

Central nervous system involvement occurs in 50-60% of children infected with human immunodeficiency virus (HIV). Most neurological tests do not reliably monitor the course of neurological disease. Somatosensory-evoked potentials (SSEP) have been suggested as a useful test to monitor neurological disease progression. However, results may be biased by confounding factors such as intrauterine drug exposure, exposure to HIV itself or neonatal complications. We studied SSEP in 18 children (14 male), ages 6 mos to 8 yrs, 12 were infected with HIV, 6 were exposed to HIV in utero. None had a history of neonatal complications. About 30% of the mothers had a history of IVDU. All infected children were being treated with antiretrovirals. 50% of the infected patients had microcephaly, 56% had an abnormal motor exam and IQ ranged from 50 to 109. Median CD4 count at testing was 657. SSEP were obtained using independent averages of 2,000 trials with 200 µsec monophasic rectangular 3.1 Hz pulses delivering 5 to 20 mA to produce a reliable motor twitch. The results are shown in the table as percentages:

Table 1 No caption
Full size table

In HIV-infected children SSEP abnormalities were not related to duration of disease, CD4 count at testing, disease stage or treatment. We conclude that SSEP abnormalities are more frequent in HIV-infected than exposed children (p=.08) and are not affected by confounding factors, thus reflecting the degree of underlying neurological disease. This study suggests that SSEP results may be a reliable neurological marker for long-term follow-up of HIV-infected children and we plan to administer additional tests to determine if the trends seen here reach statistical significance in a larger sample.