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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Early Antiretroviral Therapy is Protective against Epilepsy in Children with Human Immunodeficiency Virus Infection in Botswana</title><author><name sortKey="Bearden, David" sort="Bearden, David" uniqKey="Bearden D" first="David" last="Bearden">David Bearden</name><affiliation><nlm:aff id="A1">Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Steenhoff, Andrew P" sort="Steenhoff, Andrew P" uniqKey="Steenhoff A" first="Andrew P." last="Steenhoff">Andrew P. Steenhoff</name><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A4">Division of Infectious Disease, Children's Hospital of Philadelphia</nlm:aff></affiliation></author><author><name sortKey="Dlugos, Dennis J" sort="Dlugos, Dennis J" uniqKey="Dlugos D" first="Dennis J." last="Dlugos">Dennis J. Dlugos</name><affiliation><nlm:aff id="A1">Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</nlm:aff></affiliation></author><author><name sortKey="Kolson, Dennis" sort="Kolson, Dennis" uniqKey="Kolson D" first="Dennis" last="Kolson">Dennis Kolson</name><affiliation><nlm:aff id="A5">Division of Neurology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA</nlm:aff></affiliation></author><author><name sortKey="Mehta, Parth" sort="Mehta, Parth" uniqKey="Mehta P" first="Parth" last="Mehta">Parth Mehta</name><affiliation><nlm:aff id="A6">Texas Children's Cancer & Hematology Centers, Baylor College of Medicine, Houston, USA</nlm:aff></affiliation></author><author><name sortKey="Kessler, Sudha" sort="Kessler, Sudha" uniqKey="Kessler S" first="Sudha" last="Kessler">Sudha Kessler</name><affiliation><nlm:aff id="A1">Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Lowenthal, Elizabeth" sort="Lowenthal, Elizabeth" uniqKey="Lowenthal E" first="Elizabeth" last="Lowenthal">Elizabeth Lowenthal</name><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Department of Pediatrics, Children's Hospital of Philadelphia</nlm:aff></affiliation></author><author><name sortKey="Monokwane, Baphaleng" sort="Monokwane, Baphaleng" uniqKey="Monokwane B" first="Baphaleng" last="Monokwane">Baphaleng Monokwane</name><affiliation><nlm:aff id="A8">Department of Pediatrics, University of Botswana</nlm:aff></affiliation></author><author><name sortKey="Anabwani, Gabriel" sort="Anabwani, Gabriel" uniqKey="Anabwani G" first="Gabriel" last="Anabwani">Gabriel Anabwani</name><affiliation><nlm:aff id="A9">Botswana-Baylor Children's Clinical Centre of Excellence</nlm:aff></affiliation></author><author><name sortKey="Bisson, Gregory P" sort="Bisson, Gregory P" uniqKey="Bisson G" first="Gregory P." last="Bisson">Gregory P. Bisson</name><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation><affiliation><nlm:aff id="A10">Division of Infectious Disease, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25647527</idno><idno type="pmc">4446226</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4446226</idno><idno type="RBID">PMC:4446226</idno><idno type="doi">10.1097/QAI.0000000000000563</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">001936</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001936</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Early Antiretroviral Therapy is Protective against Epilepsy in Children with Human Immunodeficiency Virus Infection in Botswana</title><author><name sortKey="Bearden, David" sort="Bearden, David" uniqKey="Bearden D" first="David" last="Bearden">David Bearden</name><affiliation><nlm:aff id="A1">Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Steenhoff, Andrew P" sort="Steenhoff, Andrew P" uniqKey="Steenhoff A" first="Andrew P." last="Steenhoff">Andrew P. Steenhoff</name><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A4">Division of Infectious Disease, Children's Hospital of Philadelphia</nlm:aff></affiliation></author><author><name sortKey="Dlugos, Dennis J" sort="Dlugos, Dennis J" uniqKey="Dlugos D" first="Dennis J." last="Dlugos">Dennis J. Dlugos</name><affiliation><nlm:aff id="A1">Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</nlm:aff></affiliation></author><author><name sortKey="Kolson, Dennis" sort="Kolson, Dennis" uniqKey="Kolson D" first="Dennis" last="Kolson">Dennis Kolson</name><affiliation><nlm:aff id="A5">Division of Neurology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA</nlm:aff></affiliation></author><author><name sortKey="Mehta, Parth" sort="Mehta, Parth" uniqKey="Mehta P" first="Parth" last="Mehta">Parth Mehta</name><affiliation><nlm:aff id="A6">Texas Children's Cancer & Hematology Centers, Baylor College of Medicine, Houston, USA</nlm:aff></affiliation></author><author><name sortKey="Kessler, Sudha" sort="Kessler, Sudha" uniqKey="Kessler S" first="Sudha" last="Kessler">Sudha Kessler</name><affiliation><nlm:aff id="A1">Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation></author><author><name sortKey="Lowenthal, Elizabeth" sort="Lowenthal, Elizabeth" uniqKey="Lowenthal E" first="Elizabeth" last="Lowenthal">Elizabeth Lowenthal</name><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation><affiliation><nlm:aff id="A7">Department of Pediatrics, Children's Hospital of Philadelphia</nlm:aff></affiliation></author><author><name sortKey="Monokwane, Baphaleng" sort="Monokwane, Baphaleng" uniqKey="Monokwane B" first="Baphaleng" last="Monokwane">Baphaleng Monokwane</name><affiliation><nlm:aff id="A8">Department of Pediatrics, University of Botswana</nlm:aff></affiliation></author><author><name sortKey="Anabwani, Gabriel" sort="Anabwani, Gabriel" uniqKey="Anabwani G" first="Gabriel" last="Anabwani">Gabriel Anabwani</name><affiliation><nlm:aff id="A9">Botswana-Baylor Children's Clinical Centre of Excellence</nlm:aff></affiliation></author><author><name sortKey="Bisson, Gregory P" sort="Bisson, Gregory P" uniqKey="Bisson G" first="Gregory P." last="Bisson">Gregory P. Bisson</name><affiliation><nlm:aff id="A2">Botswana-UPenn Partnership</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</nlm:aff></affiliation><affiliation><nlm:aff id="A10">Division of Infectious Disease, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of acquired immune deficiency syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Seizures are common among patients with HIV/AIDS in the developing world and are associated with significant morbidity and mortality. Early treatment with combination antiretroviral therapy (cART) may reduce this risk by decreasing rates of central nervous system infections and HIV encephalopathy.</p></sec><sec id="S2"><title>Methods</title><p id="P2">A case-control study of new onset epilepsy among children age 0-18 years with perinatally acquired HIV/AIDS followed in Gaborone, Botswana during the period 2003-2009 was conducted. Children with epilepsy were identified and compared to age-and-sex-matched controls without epilepsy with respect to timing of cART initiation. Early treatment was defined as treatment with cART before the age of twelve months, at a CD4% of greater than 25 in children age 1-5, or at an absolute CD4 count of >350 cell/mm<sup>3</sup> in children age 5 and older.</p></sec><sec id="S3"><title>Results</title><p id="P3">We identified 29 cases of new onset epilepsy and 58 age and sex-matched controls. The most common identified etiologies for epilepsy were CNS infections and direct HIV neurotoxicity. Only 8 (28%) of the children who developed epilepsy received early treatment compared with 31 (53%) controls (OR 0.36, 95% CI 0.14-0.92, p=0.03). This effect was primarily driven by differences in rates of epilepsy among children who initiated treatment with cART between the ages of 1-5 years (11% vs. 53%, OR 0.11, 95% CI 0.01-1.1, p=0.06).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Earlier initiation of cART may be protective against epilepsy in children with HIV.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id><journal-id journal-id-type="pubmed-jr-id">21821</journal-id><journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id><journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id><journal-title-group><journal-title>Journal of acquired immune deficiency syndromes (1999)</journal-title></journal-title-group><issn pub-type="ppub">1525-4135</issn><issn pub-type="epub">1944-7884</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25647527</article-id><article-id pub-id-type="pmc">4446226</article-id><article-id pub-id-type="doi">10.1097/QAI.0000000000000563</article-id><article-id pub-id-type="manuscript">NIHMS659034</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Early Antiretroviral Therapy is Protective against Epilepsy in Children with Human Immunodeficiency Virus Infection in Botswana</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bearden</surname><given-names>David</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Steenhoff</surname><given-names>Andrew P.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Dlugos</surname><given-names>Dennis J.</given-names></name><degrees>MD, MSCE</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kolson</surname><given-names>Dennis</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Mehta</surname><given-names>Parth</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Kessler</surname><given-names>Sudha</given-names></name><degrees>MD, MSCE</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Lowenthal</surname><given-names>Elizabeth</given-names></name><degrees>MD, MSCE</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Monokwane</surname><given-names>Baphaleng</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A8">8</xref></contrib><contrib contrib-type="author"><name><surname>Anabwani</surname><given-names>Gabriel</given-names></name><degrees>MBChB, MMed</degrees><xref ref-type="aff" rid="A9">9</xref></contrib><contrib contrib-type="author"><name><surname>Bisson</surname><given-names>Gregory P.</given-names></name><degrees>MD, MSCE</degrees><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref><xref ref-type="aff" rid="A10">10</xref></contrib></contrib-group><aff id="A1"><label>1</label>Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, USA</aff><aff id="A2"><label>2</label>Botswana-UPenn Partnership</aff><aff id="A3"><label>3</label>Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania</aff><aff id="A4"><label>4</label>Division of Infectious Disease, Children's Hospital of Philadelphia</aff><aff id="A5"><label>5</label>Division of Neurology, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA</aff><aff id="A6"><label>6</label>Texas Children's Cancer & Hematology Centers, Baylor College of Medicine, Houston, USA</aff><aff id="A7"><label>7</label>Department of Pediatrics, Children's Hospital of Philadelphia</aff><aff id="A8"><label>8</label>Department of Pediatrics, University of Botswana</aff><aff id="A9"><label>9</label>Botswana-Baylor Children's Clinical Centre of Excellence</aff><aff id="A10"><label>10</label>Division of Infectious Disease, Hospital of the University of Pennsylvania, Perelman School of Medicine, Philadelphia, USA</aff><author-notes><corresp id="FN1">Corresponding author: David Bearden, Phone: (215) 983-9766, Fax (215) 590-1771, 10<sup>th</sup> Floor Colket Translational Research Building, 3400 Civic Center Blvd, Philadelphia, PA 19104, <email>bearden@email.chop.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>30</day><month>1</month><year>2015</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>6</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>6</month><year>2016</year></pub-date><volume>69</volume><issue>2</issue><fpage>193</fpage><lpage>199</lpage><pmc-comment>elocation-id from pubmed: 10.1097/QAI.0000000000000563</pmc-comment>
<abstract><sec id="S1"><title>Background</title><p id="P1">Seizures are common among patients with HIV/AIDS in the developing world and are associated with significant morbidity and mortality. Early treatment with combination antiretroviral therapy (cART) may reduce this risk by decreasing rates of central nervous system infections and HIV encephalopathy.</p></sec><sec id="S2"><title>Methods</title><p id="P2">A case-control study of new onset epilepsy among children age 0-18 years with perinatally acquired HIV/AIDS followed in Gaborone, Botswana during the period 2003-2009 was conducted. Children with epilepsy were identified and compared to age-and-sex-matched controls without epilepsy with respect to timing of cART initiation. Early treatment was defined as treatment with cART before the age of twelve months, at a CD4% of greater than 25 in children age 1-5, or at an absolute CD4 count of >350 cell/mm<sup>3</sup> in children age 5 and older.</p></sec><sec id="S3"><title>Results</title><p id="P3">We identified 29 cases of new onset epilepsy and 58 age and sex-matched controls. The most common identified etiologies for epilepsy were CNS infections and direct HIV neurotoxicity. Only 8 (28%) of the children who developed epilepsy received early treatment compared with 31 (53%) controls (OR 0.36, 95% CI 0.14-0.92, p=0.03). This effect was primarily driven by differences in rates of epilepsy among children who initiated treatment with cART between the ages of 1-5 years (11% vs. 53%, OR 0.11, 95% CI 0.01-1.1, p=0.06).</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Earlier initiation of cART may be protective against epilepsy in children with HIV.</p></sec></abstract><kwd-group><kwd>Epilepsy</kwd><kwd>Seizures</kwd><kwd>HIV</kwd><kwd>Pediatric</kwd><kwd>Botswana</kwd><kwd>Antiretroviral Therapy</kwd><kwd>Highly Active</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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