{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:25:13Z","timestamp":1793384713297,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005440","name":"Center for Scientific Review","doi-asserted-by":"publisher","award":["R01NS094037. The content is solely the responsibility of the authors and does not necessarily represent that of the US NIH"],"award-info":[{"award-number":["R01NS094037. The content is solely the responsibility of the authors and does not necessarily represent that of the US NIH"]}],"id":[{"id":"10.13039\/100005440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study describes clinical profiles including human immunodeficiency virus (HIV) disease history and seizure etiology among children living with HIV presenting with new\u2010onset seizure during the era of antiretroviral therapy (ART) in Zambia. 30\u2010day mortality and cause of death are also reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children living with HIV (CLWHIV) with new\u2010onset seizures were prospectively evaluated at one large urban teaching hospital and two non\u2010urban healthcare facilities. Interviews with family members, review of medical records, and where needed, verbal autopsies were undertaken. Two clinicians who were not responsible for the patients' care independently reviewed all records and assigned seizure etiology and cause of death with adjudication as needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From April 2016 to June 2019, 73 children (49 urban, 24 rural) were identified. Median age was 6\u00a0years (IQR 2.2\u201010.0) and 39 (53%) were male children. Seizures were focal in 36 (49%) and were often severe, with 37% presenting with multiple recurrent seizures in the 24\u00a0hours before admission or in status epilepticus. Although 36 (49%) were on ART at enrollment, only 7 of 36 (19%) were virally suppressed. Seizure etiologies were infectious in over half (54%), with HIV encephalitis, bacterial meningitis, and tuberculous meningitis being the most common. Metabolic causes (19%) included renal failure and hypoglycemia. Structural lesions identified on imaging accounted for 10% of etiologies and included stroke and non\u2010accidental trauma. No etiology could be identified in 12 (16%) children, most of whom died before the completion of clinical investigations. Twenty\u2010two (30%) children died within 30\u00a0days of the index seizure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Despite widespread ART roll out in Zambia, new\u2010onset seizure in CLWHIV occurs in the setting of advanced, active HIV disease. Seizure severity\/burden is high as is early mortality. Enhanced programs to assure early ART initiation, improve adherence, and address ART failure are needed to reduce the burden of neurological injury and premature death in CLWHIV.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12595","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T18:03:43Z","timestamp":1647713023000},"page":"315-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical characteristics and outcomes after new\u2010onset seizure among Zambian children with HIV during the antiretroviral therapy era"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0976-2007","authenticated-orcid":false,"given":"Mathura","family":"Ravishankar","sequence":"first","affiliation":[{"name":"University of Pittsburgh Medical Center  Pittsburgh Pennsylvania 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