Journal article
Seizures in children with HIV infection in South Africa: a retrospective case control study
- Abstract:
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Purpose
Data relating to the role that Human immunodeficiency virus (HIV) contributes towards seizures in HIV-infected children is limited. The management of seizures in this group is complex due to potential interactions between antiseizure medication and antiretroviral therapies. This study explores the seizure semiology and course of a population of affected children based on questions raised from a previous epidemiological study.
Methods
A retrospective case-control study of all patients presenting to an HIV neurology clinic between 2008–2015 was conducted. A multinomial logistic regression model was used to identify risk factors for seizure occurrence in HIV-infected children, as well as factors associated with seizure control.
Results
Of 227 HIV-infected children (median 82 months, interquartile range 41–109), 52 (23%) reported a past or present history of seizures. Prior bacterial meningitis (p = 0.03, OR 12.5, 95% CI 1.2–136.1), cerebrovascular accident (CVA, p = 0. 005, OR 8.1, 95% CI 1.9–34.9) and or tuberculous meningitis (TBM, p = 0.0004) was associated with an increased risk of seizures in HIV-infected children. Generalised tonic-clonic seizures were the predominant seizure type (64%) with the majority caused by an infectious aetiology (62%). Thirty-two (62%) of these patients had epilepsy in-line with the latest diagnostic criteria. HIV-infected children with epilepsy who were treated with efavirenz were more likely to have poor seizure control (OR 23.1 95% CI 3.4–159.6, p = 0.0001).
Conclusions
This study provides new data highlighting the complex clinical presentation and management challenges of HIV-infected children with seizures.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
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- Files:
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(Preview, Accepted manuscript, pdf, 759.4KB, Terms of use)
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- Publisher copy:
- 10.1016/j.seizure.2019.01.023
Authors
- Publisher:
- Elsevier
- Journal:
- Seizure More from this journal
- Volume:
- 65
- Pages:
- 159-165
- Publication date:
- 2019-01-28
- Acceptance date:
- 2019-01-19
- DOI:
- ISSN:
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1059-1311
- Pmid:
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30721872
- Language:
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English
- Keywords:
- Pubs id:
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pubs:972193
- UUID:
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uuid:91fb9a07-089a-4609-b636-c7dd02077db1
- Local pid:
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pubs:972193
- Source identifiers:
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972193
- Deposit date:
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2019-06-03
Terms of use
- Copyright holder:
- British Epilepsy Association
- Copyright date:
- 2019
- Rights statement:
- © 2019 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
- Notes:
- This is the accepted manuscript version of the article. The final version is available online from Elsevier at: https://doi.org/10.1016/j.seizure.2019.01.023
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