The neuropathology of HIV-infected African children in Abidjan, Cote d'Ivoire

In an autopsy study of EW-infected children in Abidjan, Cote d'Ivoire, the neuropathology of 76 HIV-1- and 2 HIV-2-positive children was compared with that of 77 frequency-matched HIV-negative children, in whom the systemic pathology was also known. Seventy of the 78 HIV-seropositive children were confirmed as HIV-infected, as determined by combined serology, IgA ,Western blots and clinicopathological criteria. The HIV-negative children showed a high background level (n = 49, 64%) of neuropathological abnormalities, including nonspecific inflammatory infiltrates, micromineralization. and bacterial and lymphocytic meningitis. In the HIV-positive children, HIV encephalitis was found in 4 (6%), cytomegalovirus in 2 (3%), toxoplasmosis in 3 (4%) and measles encephalitis in one (1%). Bacterial meningitis was equally common in both groups, but cerebral malaria was less common (n = 2, 3%) in HN-positive than in HIV-negative children (n = 11, 14%). The low prevalence of HN encephalitis may reflect comparatively early death in HN infection in Africa as compared with our experience in Europe and the US.