Neurological and psychological evolution of adolescents with vertical transmission HIV infection

AIM: Personal experience in a sample Group of children with AIDS vertically transmitted followed from Birth to adolescence (out of 56 cases with documented HIV infection, 9 who have reached the age of 13 have been studied is presented. METHODS: The evaluation protocolo includes: hematochemical, serological and virological tests to monitor the infectious status, as well as annual EEG, CT/MRI scan to detect anatomical alteration of CNS, neurological examination, intelligence test (WISC-R), interview and projective test (Blacky Pictures) to investigate emotional situation. RESULTS: As to the status of the disease, according to the CDC classification, 2 patients are asymptomatic, 2 paucisymptomatic, 2 with moderate symptoms, 2 severely symptomatic; 1 patient died due to progressive encephalopathy. Of the 2 severely symptomatic cases, 1 presents cortical atrophy adn the other basal nuclei calcifications. No one of them has clinical signs of encephalopathy. All patients receive anti-retroviral medications. From tests and interviews emotional problem-emerge, future is seen as menacing and insidious, and defensive mechanisms are fragile and inconstant, denial can lead to a refusal of the pharmacological therapy; famileis thmselves oftern refuse medical staff the consent to communicative the diagnosis fearing that this could induce unbearable anguish. CONCLUSIONS: It seems important that patients are ifnormed, considering their capacity to make front to the communication, even if one must bear in mind that understanding and accepting the diagnosis may be a logn and painful process requiring a long time.