Cognitive Assessment of Human Immunodeficiency Virus-Exposed Children

Levenson, Richard L.; Mellins, Claude A.; Zawadzki, Rezi; Kairam, Ram; Stein, Zena

doi:10.1001/archpedi.1992.02160240089028

Cited by 23 publications

(22 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is likely that central nervous system HIV infection in children results in frontostriatal dysfunction (Adam et al, 2003). Consistent with other studies, children with HIV infection in our study tended to score lowest in verbal, memory, and quantitative scales compared to their uninfected peers, though it is not statistically significant (Baillieu & Potterton, 2008;Boivin et al, 2013;Levenson, Mellins, Zawadzki, Kairam, & Stein, 1992;Sherr et al, 2009;Van et al, 2008). Two studies (Bisiacchi, Suppiej, & Laverda, 2000;Koekkoek et al, 2008) reported executive function deficits as the most sensitive cognitive measure in relation to HIV disease progression.…”

Section: Discussionsupporting

confidence: 88%

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

Kandawasvika

Kuona

Chandiwana³

et al. 2014

Child Neuropsychology

View full text Add to dashboard Cite

With long-term survival of children infected with HIV, information on cognitive function at school age is needed. To determine cognitive function among 6- to 8 year-old children exposed to HIV and to assess factors associated with cognitive impairment, we conducted a cross-sectional study from October 2010 to December 2011 among children whose mothers participated in a national HIV prevention program in Harare. Cognitive function was assessed using the McCarthy Scales of Children's Abilities (MSCA). Of the 306 assessed children, 32 (10%) were HIV infected, 121 (40%) exposed uninfected, and 153 (50%) unexposed uninfected. The mean (SD) General Cognitive Index for the whole study group was 82 (15). An overall of 49 (16%) out of the 306 children had cognitive impairment with no difference in general cognitive function among the three groups. Children with HIV infection scored lowest in perceptual performance domain, p = .028. Unemployed caregivers, child orphanhood and undernutrition were associated with impaired cognitive performance in univariate analysis. In multivariate analysis, caregiver unemployment status remained a factor associated with cognitive impairment with an ODDS ratio of 2.1 (95% CI 1.03-3.36). In a cohort of 6- to 8-year-olds, HIV infection did not show evidence of significant difference in general cognitive function. Children infected with HIV had major deficits in perceptive performance. Lower socioeconomic status was associated with cognitive impairment. In resource-constrained settings, strategies aimed at poverty alleviation and good nutritional management should complement early infant diagnosis and treatment of HIV in order to optimize neurocognitive potential.

show abstract

Section: Discussionsupporting

confidence: 88%

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

Kandawasvika

Kuona

Chandiwana³

et al. 2014

Child Neuropsychology

View full text Add to dashboard Cite

show abstract

“…Millions of babies are born each year infected with the neurotropic AIDS which has adverse consequences on fetal brain development [Livenson et al, 1992]. Until quite recently, however, maternal infection was not prominent in research on causation of neurodevelopmental disorders.…”

Section: Epidemiologic Evidence For a Role Of Prenatal Infection In Tmentioning

confidence: 99%

In utero infection and adult schizophrenia

Brown

Süsser

2002

Ment. Retard. Dev. Disabil. Res. Rev.

230

131

View full text Add to dashboard Cite

We review emerging evidence indicating that in utero exposure to infection is a risk factor for schizophrenia. It is hypothesized that a prenatal infection increases the liability to schizophrenia in adulthood by adversely affecting the maturation of critical brain structural and functional components implicated in the pathogenesis and pathophysiology of the disorder. Early evidence for a role of in utero infection includes investigations linking schizophrenia with birth during the winter and in urban regions, and ecologic studies demonstrating associations between influenza epidemics and births of pre-schizophrenic patients. The findings of the latter studies are, however, equivocal. To more rigorously address this question, our group has used increasingly sophisticated research designs that incorporate more refined measures of exposure and outcome, and continuous follow-up of treated cases. This work has already yielded several intriguing findings, including associations between schizophrenia and two in utero infections--rubella and respiratory infection. We also describe our ongoing birth cohort investigations that are expected to advance this work further, including studies that utilize maternal serum samples drawn during pregnancy of offspring who were later diagnosed with schizophrenia.

show abstract

“…HIV-infected children present with a wide range of disabilities, including generalized cognitive defects, 5 motor deficits, 6;7 and visual, 8–10 language, 7;11;12 or learning disorders 7;13 . These deficits are thought to result from the increased risk to central nervous system as the HIV virus can permeate the blood-brain barrier 14 .…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental Benefits of Antiretroviral Therapy in Ugandan Children Aged 0–6 Years With HIV

Brahmbhatt

Boivin

Ssempijja

et al. 2014

JAIDS Journal of Acquired Immune Deficiency Syndromes

View full text Add to dashboard Cite

Background Insufficient data on neurodevelopmental benefits of antiretroviral therapy (ART) in children. Methods Prospective study of 329 mothers and children aged 0–6 years to assess neurodevelopment. Results stratified by the maternal (M) and child (C) HIV status (MHIV−/CHIV−, MHIV+/CHIV−, and MHIV+/CHIV+). Gross Motor, Visual Reception, Fine Motor, Receptive and Expressive Language scores assessed by Mullen Scales of Early Learning. Global cognitive function was derived from an Early Learning Composite score (ELC). Standardized Weight and Height for Age z-scores were constructed and the lowest 15% cutoff defined disability. Generalized linear models were used to estimate Prevalence Rate Ratios (PRR) adjusted for the child’s age, weight and height. In HIV-positive children, generalized linear models assessed the impact of ART initiation and duration on neurodevelopment. Results Compared to MHIV−/CHIV− children, HIV+ children were more likely to have global deficits in all measures of neurodevelopment except gross motor skills, whereas in MHIV+/CHIV− children, there was impairment in receptive language (adj.PRR=2.67, CI: 1·08, 6.60) and the ELC (adj.PRR=2.94, CI: 1.11, 7.82). Of the children born to HIV positive mothers, HIV+ children did worse than - MHIV+/CHIV− only in Visual Reception skills (adj.PRR=2.86; CI: 1.23–6.65). Of the 116 HIV+ children, 44% had initiated ART. Compared to ART duration of <12 months, ART durations 24–60 months was associated with decreased impairments in Fine Motor, Receptive Language, Expressive Language and ELC scores. Conclusions Longer duration on ART is associated with reduction of some neurologic impairment and early diagnosis and treatment of HIV+ children is a priority.

show abstract

Cognitive Assessment of Human Immunodeficiency Virus-Exposed Children

Cited by 23 publications

References 13 publications

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

The burden and predictors of cognitive impairment among 6- to 8-year-old children infected and uninfected with HIV from Harare, Zimbabwe: A cross-sectional study

In utero infection and adult schizophrenia

Neurodevelopmental Benefits of Antiretroviral Therapy in Ugandan Children Aged 0–6 Years With HIV

Contact Info

Product

Resources

About