Neurologic and neurodevelopmental problems were investigated in a cohort of 39 human immunodeficiency virus (HIV)-infected children and 164 antibody-negative children born to HIV-positive women. All children were followed from birth for between 1 month and 4 years. Serious neurologic manifestations were present in 5 of 16 children (31%) who developed acquired immunodeficiency syndrome/acquired immunodeficiency syndrome-related complex, although in 2 the neurologic signs were probably not related to HIV. This can be compared with a prevalence of 0 of 23 in children who remained asymptomatic or who had less severe HIV-related symptoms or signs and 2 of 164 (1%) in uninfected children. Neurologic signs in the uninfected group were associated with the presence of drug withdrawal at birth and prematurity. These findings contrast with reports of a high prevalence of neurologic findings in most studies of HIV-infected children.
