Perinatal HIV in the brain Mission incomplete despite combination antiretroviral therapy

HIV remains a global threat, with more than 3 million children worldwide living with this disease. Many HIV-infected (HIV+) children have neurologic complications that can lead to functional impairments and developmental delays.(1) The expansion of effective combination antiretroviral therapy (cART) programs across resource-limited countries (e.g., President's Emergency Plan for AIDS Relief), has led to prolonged survival of vertically transmitted HIV+ children, with many now progressing into adolescence or adulthood. However, important differences exist between vertical and horizontal transmission.(2) Challenges continue concerning how to establish the true cognitive status of the developing brain, given that neuropsychological performance (NP) is constantly changing during this period. Structural and functional neuroimaging may provide a noninvasive mechanism that helps reduce cultural and attentional confounds seen with NP testing.(3</SUP)