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ABSTRACT. Background. The neurodevelopmental outcomes of human immunodeficiency virus type 1 (HIV-1)-infected Ugandan infants of nondrug-using mothers were studied using controlled, prospective methodology.Method. The sample of 436 full-term infants included 79 HIV-infected infants of HIV-1-infected mothers, 241 uninfected infants of HIV-1-infected mothers (seroreverters), and 116 uninfected infants born to HIV-negative mothers. Neurologic status, information processing ability, and motor and mental development were assessed from 6 to 24 months of age. Observations of caretaker-child interaction and home environments were made at 6 and 12 months. All evaluators were blinded to the HIV status of the child and family.Results. Compared with seroreverters and uninfected infants, HIV-infected infants demonstrated greater deficits in motor development and neurologic status, and more frequent and earlier onset of motor and neurologic abnormalities. Compared with controls, HIV-infected infants had more abnormalities in mental development at 6 and 18 months and an earlier onset of abnormalities. By 12 months, 30% of HIV-infected infants demonstrated motor abnormalities and 26% cognitive abnormalities as compared with 11% and 6% among seroreverters and 5% and 6% among seronegative infants. HIV-infected infants (62%) demonstrated a higher probability of developing an abnormal neurologic examination by 12 months, compared with seroreverters (17%) or seronegative infants (15%). Information-processing abilities did not differ as a function of HIV infection. Home environments and infants' interactions with caretakers were similar across groups.Conclusion. We conclude that HIV infection results in more frequent and earlier abnormalities in infants' neurologic status and motor development that are not attributable to other biological and environmental risk factors. More frequent mental developmental abnormalities were evident at several ages. However, informationprocessing abilities, such as recognition memory, may be spared from HIV-related deficits. Pediatrics 1997;100(1). URL: http://www.pediatrics.org/cgi/content/full/100/1/e5; HIV infection, neurodevelopment, mental development, motor development, neurological status, information processing ability.ABBREVIATION. HIV, human immunodeficiency virus.T he prevalence of human immunodeficiency virus type 1 (HIV-1) in infants and young children in the United States and in the world has dramatically increased. [1][2][3][4] Prevalence rates of HIV infection, which are now more than one million children worldwide, indicate that HIV-1-related central nervous system disease will become a significant cause of mental deficiency and developmental disabilities in the United States and worldwide. 5 Generalized cognitive deficiencies, 6 -14 language 15 and motor 9 deficits, and variation in the type and severity of developmental and neurologic deficits have been consistently reported. 8 -16 For this reason, there is a continuing need for controlled studies of neurodevelopmental outcomes amon...

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