Brain Imaging and Neurodevelopment in HIV-uninfected Thai Children Born to HIV-infected Mothers

Jahanshad, Neda; Couture, Marie Claude; Prasitsuebsai, Wasana; Nir, Talia M.; Aurpibul, Linda; Thompson, Paul M.; Pruksakaew, Kanchana; Lerdlum, Sukalaya; Visrutaratna, Pannee; Catella, Stephanie; Desai, Akash; Kerr, Stephen J.; Puthanakit, Thanyawee; Paul, Robert; Ananworanich, Jintanat; Valcour, Victor

doi:10.1097/inf.0000000000000774

Cited by 23 publications

(29 citation statements)

References 52 publications

(55 reference statements)

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“…Abnormal Dubowitz neurobehavioral scores were positively correlated with FA in the left uncinate fasciculus and negatively correlated with diffusivity in the right inferior cerebellar peduncle and bilateral hippocampal cingulum in HEU infants . The third study using DTI in age‐matched HEU and HUU children did not detect group differences in intelligence quotient (IQ) scores, brain volume, or DTI metrics, after controlling for sociodemographic factors . This study found that DTI measures were significantly associated with full scale and performance IQ scores, showing positive associations with FA and negative associations with diffusivity metrics.…”

Section: Resultsmentioning

confidence: 69%

“…Post‐screening, 255 full‐text articles were critically reviewed, and 25 met inclusion criteria for the systematic review (Figure ). Five articles included human subjects and studied brain size, structure and function . The remaining 20 articles were preclinical studies using animal models mostly focused on behavioural assessments (see Tables and for study characteristics and summary of outcomes).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies looked at magnetic resonance imaging (MRI) findings in HEU populations; two were performed in South Africa , one in France and one in Thailand . In terms of methodological quality, one study was rated as good , two were fair‐good and two were fair . Three studies used diffusion tensor imaging (DTI) .…”

Section: Resultsmentioning

confidence: 99%

“…In terms of methodological quality, one study was rated as good , two were fair‐good and two were fair . Three studies used diffusion tensor imaging (DTI) . Two noted regionally higher fractional anisotropy (FA) and predominantly lower diffusivity in HEU compared to HUU, in both neonates and children .…”

Section: Resultsmentioning

confidence: 99%

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In utero exposure to HIV and/or antiretroviral therapy: a systematic review of preclinical and clinical evidence of cognitive outcomes

et al. 2019

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Introducion With the increasing number of children exposed to HIV or antiretroviral therapy in utero, there are concerns that this population may have worse neurodevelopmental outcomes compared to those who are unexposed. The objective of this study was to systematically review the clinical and preclinical literature on the effects of in utero exposure to HIV and/or antiretroviral therapy ( ART ) on neurodevelopment. Methods We systematically searched OVID Medline, Psyc INFO and Embase, as well as the Cochrane Collaborative Database, Google Scholar and bibliographies of pertinent articles. Titles, abstracts, and full texts were assessed independently by two reviewers. Data from included studies were extracted. Results are summarized qualitatively. Results The search yielded 3027 unique titles. Of the 255 critically reviewed full‐text articles, 25 met inclusion criteria for the systematic review. Five articles studied human subjects and looked at brain structure and function. The remaining 20 articles were preclinical studies that mostly focused on behavioural assessments in animal models. The few clinical studies had mixed results. Some clinical studies found no difference in white matter while others noted higher fractional anisotropy and lower mean diffusivity in the brains of HIV ‐exposed uninfected children compared to HIV ‐unexposed uninfected children, correlating with abnormal neurobehavioral scores. Preclinical studies focused primarily on neurobehavioral changes resulting from monotherapy with either zidovudine or lamivudine. Various developmental and behavioural changes were noted in preclinical studies with ART exposure, including decreased grooming, decreased attention, memory deficits and fewer behaviours associated with appropriate social interaction. Conclusions While the existing literature suggests that there may be some neurobehavioral differences associated with HIV and ART exposure, limited data are available to substantially support these claims. More research is needed comparing neurobiological factors between HIV ‐exposed uninfected and HIV ‐unexposed uninfected children and using exposures consistent with current clinical care.

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Section: Resultsmentioning

confidence: 69%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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In utero exposure to HIV and/or antiretroviral therapy: a systematic review of preclinical and clinical evidence of cognitive outcomes

et al. 2019

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“…A key goal in scanning these cohorts is to establish growth rate “norms” based on as much statistical data as possible. Despite the large effect sizes for structural brain differences in elderly cohorts with HIV [37], brain differences between HIV+ and HIV- children have been more difficult to identify [38]. …”

Section: Introductionmentioning

confidence: 99%

Novel Neuroimaging Methods to Understand How HIV Affects the Brain

Thompson

Jahanshad

2015

Curr HIV/AIDS Rep

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In much of the developed world, the HIV epidemic has largely been controlled by anti-retroviral treatment. Even so, there is growing concern that HIV-infected individuals may be at risk for accelerated brain aging, and a range of cognitive impairments. What promotes or resists these changes is largely unknown. There is also interest in discovering factors that promote resilience to HIV, and combat its adverse effects in children. Here we review recent developments in brain imaging that reveal how the virus affects the brain. We relate these brain changes to changes in blood markers, cognitive function, and other patient outcomes or symptoms, such as apathy or neuropathic pain. We focus on new and emerging techniques, including new variants of brain MRI. Diffusion tensor imaging, for example, can map the brain’s structural connections while fMRI can uncover functional connections. Finally, we suggest how large-scale global research alliances, such as ENIGMA, may resolve controversies over effects where evidence is now lacking. These efforts pool scans from tens of thousands of individuals, and offer a source of power not previously imaginable for brain imaging studies.

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Cognitive and Language Development at Age 4–6 Years in Children HIV‐Exposed But Uninfected Compared to Those HIV‐Unexposed and to Children Living With HIV

Gruver

Kvalsvig

Knox

et al. 2020

New Directions for Child and Adolescent Development

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Perinatal HIV infection is associated with delayed neurocognitive development, but less is known about children perinatally HIV‐exposed but uninfected (CHEU). We compared cognitive and language outcomes in 4–6‐year old CHEU versus children HIV‐unexposed and uninfected (CHUU) and children living with HIV (CLHIV). We enrolled 1,581 children (77% of the child population) in five communities in KwaZulu‐Natal, South Africa. Children completed: Grover‐Counter Scale of cognitive development, sub‐scales of the Kaufman Assessment Battery for Children, Reynell Developmental Language Scales. HIV status of children and primary caregivers was determined by repeated rapid tests or report of prior testing. We conducted a cross‐sectional multivariable linear regression on 922 dyads with complete data (257 CHEU, 627 CHUU, 38 CLHIV). On all outcome measures, CHEU and CHUU groups had comparable scores; CLHIV scored significantly lower. Emerging global progress toward the elimination of vertical HIV transmission may not only reduce mortality, but also positively impact child development.

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Brain Imaging and Neurodevelopment in HIV-uninfected Thai Children Born to HIV-infected Mothers

Cited by 23 publications

References 52 publications

In utero exposure to HIV and/or antiretroviral therapy: a systematic review of preclinical and clinical evidence of cognitive outcomes

In utero exposure to HIV and/or antiretroviral therapy: a systematic review of preclinical and clinical evidence of cognitive outcomes

Novel Neuroimaging Methods to Understand How HIV Affects the Brain

Cognitive and Language Development at Age 4–6 Years in Children HIV‐Exposed But Uninfected Compared to Those HIV‐Unexposed and to Children Living With HIV

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