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and developed seizures and epilepsy afterwards, and one HIV, early detection of HIV infection and swift initiation of
patient developed seizures as a neonate after suffering from ART in children are crucial, and delays will impact on school
a hypoxic–ischaemic event during birth. As the type of performance and thus on future socio-economic status,
epilepsy was mostly not described in the notes and as most keeping the spiral of poverty going. The new South African
children were unable to receive EEG readings, it is likely that HIV guidelines from 2017, which made it possible to start
epilepsy syndromes like absence epilepsy or childhood immediate highly active antiretroviral therapy (HAART) on
epilepsy with centro-temporal spikes may have been missed. every person diagnosed with HIV infection, address this
The prevalence of these disorders, however, is low in high issue. Unfortunately, in low-resource areas like the Eastern
30
resource settings, but unknown in South Africa. Cape, early diagnosis in children and infants is still a
Furthermore, besides CD4 counts and VL, limited laboratory challenge and this needs to be addressed.
investigations were available for most children, which is a
further limitation of this study. In more than one-third of Acknowledgements
children, the aetiology could not be established, which is
slightly higher than that in other studies in children and Competing interests
adults. 19,31,32,33 The authors have declared that no competing interest
exists.
In our cohort, almost half of the children with epilepsy
became seizure-free and another 16% had a significant
reduction (50% – 75%) of seizure frequency. The tight Authors’ contributions
follow-up schedule to assure adherence to ART, and thus All authors contributed equally to this work.
to antiepileptic treatment, might have contributed to this
outcome. Funding information

One big concern is the high percentage of the epileptic This research received no specific grant from any funding
children in our cohort with school problems (55%). It is agency in the public, commercial or not-for-profit sectors.
known that many children with perinatal acquired HIV
infection show neurodevelopmental delay. 3,15,16,34 Human Data availability statement
immunodeficiency virus-positive preschool and school
children had global deficits in all measures of Data sharing is not applicable to this article as no new data
neurodevelopment, except gross motor skills, in a study from were created or analysed in this study.
Uganda. 35,36,37 Compared to their non-exposed and non-
infected classmates, two to three times more HIV-infected Disclaimer
children struggled with language, visual perception and fine The views and opinions expressed in this article are those of
motor skills. A study conducted in Congo showed that the authors and do not necessarily reflect the official policy or
children infected with HIV had a significantly higher position of any affiliated agency of the authors.
incidence, up to 91%, of neurodevelopmental deficits in all
domains compared to uninfected children. Newer studies References
37
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http://www.sajhivmed.org.za 410 Open Access