Early Language Development in Children Exposed to or Infected With Human Immunodeficiency Virus

Coplan, James; Contello, Kathie A.; Cunningham, Coleen K.; Weiner, Leonard B.; Dye, Timothy D.; Roberge, Linda; Wojtowycz, Martha A.; Kirkwood, Kim

doi:10.1542/peds.102.1.e8

Cited by 43 publications

(30 citation statements)

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“…Receptive language is more dependent on the working memory of the child in response to the items being presented, and may be a consequence of maternal illness and lack of an environment conducive to language learning. Although there is improvement in language skills after ART use in some studies 36 , others find no impact of ART on reversal of language delay, despite benefits in overall cognitive performance with extended ART use 37 . We found significant improvements in both Receptive and Expressive Language scores with extended ART use among HIV+ children.…”

Section: Discussionmentioning

confidence: 95%

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

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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.

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Section: Discussionmentioning

confidence: 95%

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

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“…Significant improvements in child nutritional and growth status have been made with the use of ART (Jaspan, et al, 2008;Eley, et al, 2006;Verweel, et al, 2002). Positive, but limited improvements in neurodevelopmental functioning have been reported in numerous studies, however, these improvements did not reverse the existing neurodevelopmental impairment (Lindsey, et al, 2007;Foster, et al, 2006;Coplan, et al, 1998;Raskino, et al, 1999;Pizzo, et al, 1988). Despite ART, neurodevelopmental impairments persist due to existing regions of the CNS having sustained injury at critical periods of brain development (Foster, et al, 2006;Willen, 2006), as well as the blood-brain barrier (BBB) effectively preventing adequate permeation of ART into the CNS to suppress viral replication (Letendre, et al, 2008;Miller, 2002).…”

Section: Antiretroviral Eramentioning

confidence: 99%

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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The aim of this cross-sectional study was to determine the difference in development (cognition; receptive and expressive language; and fine and gross motor) of Human Immunodeficiency Virus (HIV) -exposed infected (HEI) infants with the development of HIV-exposed but uninfected (HEU) infants using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sixty infants were enrolled in the study; 32 (53.33%) HEU infants and 28 (46.67%) HEI infants. The two groups were well-matched for infant demographics, anthropometry at birth, maternal demographics, as well as socioeconomic status. Statistically significant differences were found in anthropometry and development between the HEI and HEU group. The HEI infants had malnutrition, were stunted and had smaller head circumferences than HEU infants. The BSID-III showed that the mean developmental delay for the HEI group was approximately two months below their mean chronological age for all scales (cognitive; receptive and expressive communication; and, fine and gross motor age).The HEI group showed that 64.29% had cognitive delay, 60.71% had language delay and 53.57% had motor delay, all of which was significantly different from the development of the HEU group for all domains (p<0.001). In addition to using the BSID-III, the majority of mothers were able to correctly indicate whether their child was developing at the same, or at a slower rate of development than children of the same age. This study demonstrates that infants who are HIV-exposed and infected are at risk of developmental delay.

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“…39 Language deficits have also been commonly reported in children with HIV infection. 1,18,27,40,41 Language ability is strongly related to academic performance, and these children show declines in academic achievement, especially in mathematics. 31,42 Findings such as these underscore the importance of examining performance in specific domains (eg, language, psychomotor speed) in addition to administering global measures of neuropsychological functioning (eg, Full-Scale IQ).…”

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confidence: 99%

Predicting HIV Disease Progression in Children Using Measures of Neuropsychological and Neurological Functioning

et al. 2000

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ABSTRACT. Background. Neuropsychological testing and 2 measures of neurological status, cortical atrophy, and motor dysfunction were assessed for their usefulness in predicting human immunodeficiency virus (HIV) disease progression in infants, children, and adolescents who participated in Pediatric AIDS Clinical Trials Group Protocol 152 (PACTG 152).Methods. A cohort of 722 antiretroviral therapy-naive children with symptomatic HIV infection were assessed at study entry and at later intervals. Assessments included neurodevelopmental testing, neuroradiologic imaging, and neurological examination of motor function. CD4 cell count and plasma RNA viral load also were measured.Results. Children with the lowest neuropsychological functioning (IQ < 70) at baseline had the highest risk for later HIV disease progression (56%), compared with those with borderline/low (IQ ‫؍‬ 70 -89) functioning (26%), or with average or above (IQ > 90) functioning (18%). This was also true of week 48 neuropsychological functioning. Motor dysfunction (especially reduced muscle mass) at entry also predicted disease progression. Furthermore, motor dysfunction and week 48 neuropsychological functioning provided predictive information beyond that obtainable from surrogate markers of HIV disease status (eg, CD4 count, HIV RNA level). Children with cortical atrophy also were at higher risk for later disease progression, but when CD4 count and RNA viral load were known, cortical atrophy information provided no additional predictive information.Conclusions. Measures of neuropsychological and motor function status provide unique information regarding pediatric HIV disease progression. As such, these findings have important implications for predicting long-term outcomes (eg, longevity) in pediatric patients. Pediatrics 2000;106(6). URL: http://www. pediatrics.org/cgi/content/full/106/6/e76; human immunodeficiency virus, children, neuropsychology, cognitive, development, cortical atrophy, motor function.

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Early Language Development in Children Exposed to or Infected With Human Immunodeficiency Virus

Cited by 43 publications

References 10 publications

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

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

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Predicting HIV Disease Progression in Children Using Measures of Neuropsychological and Neurological Functioning

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