{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:10:02Z","timestamp":1756728602108,"version":"3.44.0"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:00:00Z","timestamp":1708128000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["K23NS117310","R01NS094037","R35NS122265"],"award-info":[{"award-number":["K23NS117310","R01NS094037","R35NS122265"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the long\u2010term outcomes, including mortality and recurrent seizures, among children living with HIV (CLWH) who present with new onset seizure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Zambian CLWH and new onset seizure were enrolled prospectively to determine the risk of and risk factors for recurrent seizures. Demographic data, clinical profiles, index seizure etiology, and 30\u2010day mortality outcomes were previously reported. After discharge, children were followed quarterly to identify recurrent seizures and death. Given the high risk of early death, risk factors for recurrent seizure were evaluated using a model that adjusted for mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 73 children enrolled, 28 died (38%), 22 within 30\u2010days of the index seizure. Median follow\u2010up was 533\u2009days (IQR 18\u2013957) with 5% (4\/73) lost to follow\u2010up. Seizure recurrence was 19% among the entire cohort. Among children surviving at least 30\u2010days after the index seizure, 27% had a recurrent seizure. Median time from index seizure to recurrent seizure was 161\u2009days (IQR 86\u2013269). Central nervous system opportunistic infection (CNS OI), as the cause for the index seizure was protective against recurrent seizures and higher functional status was a risk factor for seizure recurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Among CLWH presenting with new onset seizure, mortality risks remain elevated beyond the acute illness period. Recurrent seizures are common and are more likely in children with higher level of functioning even after adjusting for the outcome of death. Newer antiseizure medications appropriate for co\u2010usage with antiretroviral therapies are needed for the care of these children. CNS OI may represent a potentially reversible provocation for the index seizure, while seizures in high functioning CLWH without a CNS OI may be the result of a prior brain injury or susceptibility to seizures unrelated to HIV and thus represent an ongoing predisposition to seizures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>This study followed CLWH who experienced a new onset seizure to find out how many go on to have more seizures and identify any patient characteristics associated with having more seizures. The study found that mortality rates continue to be high beyond the acute clinical presentation with new onset seizure. Children with a CNS OI causing the new onset seizure had a lower risk of later seizures, possibly because the trigger for the seizure can be treated. In contrast, high functioning children without a CNS OI were at higher risk of future seizures.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epi4.12921","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T06:29:55Z","timestamp":1708151395000},"page":"750-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term outcomes after new onset seizure in children living with <scp>HIV<\/scp>: A cohort study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0735-3461","authenticated-orcid":false,"given":"Gretchen L.","family":"Birbeck","sequence":"first","affiliation":[{"name":"Department of Neurology University of Rochester  Rochester New York USA"},{"name":"University Teaching Hospitals Children's Hospital  Lusaka Zambia"},{"name":"Chikankata Epilepsy Care Team  Mazabuka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Musaku","family":"Mwenechanya","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals Children's Hospital  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ifunanya","family":"Ume\u2010Ezeoke","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manoj","family":"Mathews","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals Children's Hospital  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Bositis","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Kalungwana","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Zambia  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Bearden","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester  Rochester New York USA"},{"name":"University Teaching Hospitals Children's Hospital  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Elafros","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Michigan  Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harris A.","family":"Gelbard","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4669-5747","authenticated-orcid":false,"given":"William H.","family":"Theodore","sequence":"additional","affiliation":[{"name":"Clinical Epilepsy Section US National Institute of Health  Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor J.","family":"Koralnik","sequence":"additional","affiliation":[{"name":"Department of Neurology Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason F.","family":"Okulicz","sequence":"additional","affiliation":[{"name":"Department of Medicine San Antonio Military Medical Center  San Antonio Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Rochester  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Namwiya","family":"Musonda","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals Neurology Research Office  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar K.","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals Children's Hospital  Lusaka Zambia"},{"name":"Department of Neurology Beth Israel Deaconess Medical Center  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Potchen","sequence":"additional","affiliation":[{"name":"Department of Imaging Sciences University of Rochester  Rochester New York USA"},{"name":"Zambian College of Medicine and Surgery  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izukanji","family":"Sikazwe","sequence":"additional","affiliation":[{"name":"Centre for Infectious Disease Research in Zambia  Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,17]]},"reference":[{"unstructured":"UNAIDS.Global HIV and AIDS Statistics Facts Sheet 2023. Available from:https:\/\/www.unaids.org\/en\/resources\/fact\u2010sheet. Accessed 14 February 2024.","key":"e_1_2_8_2_1"},{"volume-title":"Sixth stocktaking report: towards an AIDS\u2010free generation","year":"2013","author":"UNICEF","key":"e_1_2_8_3_1"},{"key":"e_1_2_8_4_1","first-page":"682","article-title":"Initial burden of disease estimates for South Africa, 2000","volume":"93","author":"Bradshaw D","year":"2003","journal-title":"S Afr Med J"},{"doi-asserted-by":"publisher","key":"e_1_2_8_5_1","DOI":"10.1177\/0883073811405203"},{"doi-asserted-by":"publisher","key":"e_1_2_8_6_1","DOI":"10.1016\/j.seizure.2007.05.017"},{"doi-asserted-by":"publisher","key":"e_1_2_8_7_1","DOI":"10.1017\/S0317167100007009"},{"key":"e_1_2_8_8_1","first-page":"29","article-title":"New\u2010onset seizures among HIV infected drug naive patients from south India","volume":"10","author":"Sinha S","year":"2005","journal-title":"Neurol Asia"},{"key":"e_1_2_8_9_1","first-page":"255","article-title":"Acquired immunodeficiency syndrome by vertical transmission: neurological disorders","volume":"1","author":"Tellechea\u2010Rotta N","year":"2003","journal-title":"Rev Neurol"},{"doi-asserted-by":"crossref","unstructured":"FrenchJA KannerAM BautistaJ Abou\u2010KhalilB BrowneT HardenCL et\u00a0al.Efficacy and tolerability of the new antiepileptic drugs II: treatment of refractory epilepsy: report of the TTA and QSS subcommittees of the American Academy of Neurology and the American Epilepsy Society Epilepsia.2004;45:410\u2013423.","key":"e_1_2_8_10_1","DOI":"10.1111\/j.0013-9580.2004.06304.x"},{"doi-asserted-by":"publisher","key":"e_1_2_8_11_1","DOI":"10.1016\/S1474-4422(14)70114-0"},{"doi-asserted-by":"publisher","key":"e_1_2_8_12_1","DOI":"10.1111\/epi.12173"},{"doi-asserted-by":"publisher","key":"e_1_2_8_13_1","DOI":"10.1016\/S1474-4422(13)70003-6"},{"doi-asserted-by":"publisher","key":"e_1_2_8_14_1","DOI":"10.2174\/1874315300801010101"},{"doi-asserted-by":"publisher","key":"e_1_2_8_15_1","DOI":"10.1016\/j.seizure.2019.01.023"},{"doi-asserted-by":"publisher","key":"e_1_2_8_16_1","DOI":"10.1097\/QAI.0000000000000563"},{"doi-asserted-by":"publisher","key":"e_1_2_8_17_1","DOI":"10.1002\/epi4.12595"},{"doi-asserted-by":"publisher","key":"e_1_2_8_18_1","DOI":"10.1002\/1097-0142(19871001)60:7<1651::AID-CNCR2820600738>3.0.CO;2-J"},{"unstructured":"UNICEF.Pediatric Care and treatment. Available from:https:\/\/data.unicef.org\/topic\/hivaids\/paediatric\u2010treatment\u2010and\u2010care\/. Accessed 15 January 2024.","key":"e_1_2_8_19_1"},{"doi-asserted-by":"publisher","key":"e_1_2_8_20_1","DOI":"10.1111\/j.1528-1167.2011.03335.x"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12921","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T11:42:30Z","timestamp":1756726950000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.12921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,17]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/epi4.12921"],"URL":"https:\/\/doi.org\/10.1002\/epi4.12921","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"type":"print","value":"2470-9239"},{"type":"electronic","value":"2470-9239"}],"subject":[],"published":{"date-parts":[[2024,2,17]]},"assertion":[{"value":"2023-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}