Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents.

Untreated perinatally HIV-infected (PHIV) children are at increasedrisk of central nervous system (CNS) sequelae compared with HIV-infectedchildren who begin antiretroviral therapy (ART) in infancy. HIV invadesthe developing CNS earlier and with greater severity than observed inadults and with a more rapid progression to death. In addition, patientsreceiving ART may remain vulnerable to the effects of HIV on the brainbecause the CNS may be a reservoir for persistent viral replication.Initiation of ART, therefore, does not fully reverse CNS insults,particularly if treatment is not initiated during infancy.[1]Psychosocial stressors, such as poverty, orphanhood and parental illness(physical and