Effects of Pediatric HIV Infection and Prenatal Drug Exposure on Mental and Psychomotor Development

Mellins, Claude A.; Levenson, Richard L.; Zawadzki, Rezi; Kairam, Ram; Wetson, Martha

doi:10.1093/jpepsy/19.5.617

Cited by 36 publications

(28 citation statements)

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“…Literature reporting on the clinical manifestations of HIV encephalopathy in children can be confounded by: inconclusive definitions of HIV encephalopathy where only the extreme spectrum of the disease are observed; inclusion of children with opportunistic CNS infections or CNS tumours secondary to HIV; inclusion of children who may have suffered CNS damage through other factors such as intravenous drug use and/or alcohol abuse which is usually seen in studies from the developed world (Blanchette, et al, 2001;Chase, et al, 2000;Mellins, et al, 1994; and/or factors that increase poor early child development (poverty and, poor health and nutrition) which are commonly found in studies from the developing world.…”

Section: Clinical Manifestations Of Hiv Encephalopathymentioning

confidence: 99%

“…Cognitive delay in HIVinfected children has been well documented in numerous studies with a variety of clinical manifestations. These include: behavioural impairments, learning impairments, lower intellectual function, poor ability in sequential processing, attentiondeficit disorders; and spatial memory impairment (Ruel, et al, 2012;Grover, et al, 2007;Willen, 2006;Chase, et al, 2000;Blanchette, et al, 2001;Pearson, et al, 2000;Boivin, et al, 1995;Gay, et al, 1995;Brouwers, et al, 1995;Mellins, et al, 1994;.…”

Section: Cognitive Delaymentioning

confidence: 99%

“…The focus in developed countries shifted from descriptions of the effect of HIV on the CNS to documenting the extent of neurological and developmental impairment (Belman, et al, 1996;Gay, et al, 1995;Lobato, et al, 1995;and European Collaborative Study, 1990). Improvements in methodology to support this aim included: longitudinal design; smaller age ranges from birth to four years with increased sample sizes (Belman, et al, 1996;Pollack, et al, 1996;Chase, et al, 1995;Gay, et al, 1995;Mellins, et al, 1994;Nozyce, Hittelman, et al, 1994;Condini, et al, 1991;and, European Collaborative Study, 1990); employing the use of the BSID-I, a standardised assessment tool (Belman, et al, 1996;Pollack, et al, 1996;Chase, et al, 1995;Gay, et al, 1995;Mellins, et al, 1994;and, Nozyce, Hittelman, et al, 1994); introduction of control groups (Belman, et al, 1996;Pollack, et al, 1996;Chase, et al, 1995;Gay, et al, 1995;Mellins, et al, 1994;Nozyce, Hittelman, et al, 1994;Condini, et al, 1991;European Collaborative Study, 1990;and Diamond, et al, 1990); and minimising confounding factors (Belman, et al, 1996).…”

Section: Pre-antiretroviral Eramentioning

confidence: 99%

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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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Section: Clinical Manifestations Of Hiv Encephalopathymentioning

confidence: 99%

Section: Cognitive Delaymentioning

confidence: 99%

Section: Pre-antiretroviral Eramentioning

confidence: 99%

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Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Hutchings¹,

Potterton

2013

Vulnerable Children and Youth Studies

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“…However, the conclusions that can be drawn from the above studies are limited by several methodological issues that are addressed in the present study. In two of the above studies, 10,12 developmental outcome data were based entirely on unvalidated screening instruments. In the third, sensorimotor development was assessed using a standardized instrument.…”

mentioning

confidence: 99%

Neurodevelopmental Outcomes of Ugandan Infants With Human Immunodeficiency Virus Type 1 Infection

et al. 1997

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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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“…Debido a la alta prevalencia de la encefalopatía, numerosos estudios han evaluado los efectos del VIH-1 en el desarrollo cognitivo y motor de infantes nacidos de madres positivas para VIH-1; se ha encontrado que la progresión es significativamente más lenta en los pacientes positivos para VIH-1, comparada con la de los niños negativos para VIH-1 nacidos de madres positivas para VIH-1 o con individuos negativos para VIH-1 nacidos de madres no infectadas (9)(10)(11)(12)(13)(14)(15)(16). Se ha establecido claramente que esta diferencia no se debe a otros factores de riesgo que hubieran podido influir en el desarrollo neurológico como el abuso de drogas (13), la exposición perinatal a fármacos (16), o el ambiente y cuidados inadecuados (14).…”

Section: Manifestaciones Clínicas Y Alteraciones Inmunológicasunclassified

El virus de la inmunodeficiencia humana tipo 1 y el sistema nervioso central en desarrollo.

et al. 2005

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Actualmente, hay más de 42 millones de infectados con el virus de la inmunodeficiencia humana tipo 1 (VIH-1), de los cuales, 3,2 millones son niños y, de éstos, el 90% con transmisión vertical de la infección. Se considera que en Colombia más de 200.000 personas se han infectado desde el inicio de la pandemia y los estudios muestran una tendencia constante al aumento en las cifras de seroprevalencia en mujeres embarazadas y, por ende, en el número de recién nacidos infectados. El VIH-1 es primordialmente linfotrópico, pero su tropismo por el sistema nervioso central (SNC) es bien conocido, lo que genera múltiples alteraciones neurológicas, particularmente prominentes en niños, de las cuales la más prevalerte es la encefalopatía. Clásicamente, se reconocen dos tipos de encefalopatía en esta población: encefalopatía temprana y tardía, ambas con diferentes características clínicas e inmunológicas. La infección por el VIH-1 en el SNC está limitada a los macrófagos, la microglía y los astrocitos en menor escala. Las neuronas, células principalmente afectadas en los pacientes con sida, raras veces son infectadas, por lo que se postula que factores solubles, provenientes tanto del huésped como del virus, son los principales causantes del daño neuronal. Los hallazgos presentados en esta revisión sugieren la posibilidad de que el SNC, en etapas tempranas del desarrollo, sea especialmente susceptible a la infección por el VIH-1. Las cifras epidemiológicas sugieren que este tipo de alteraciones clínicas serán cada vez más frecuentes; de ahí, la importancia de conocer la neuropatogénesis de la infección por el VIH-1.Palabras clave: encefalitis, VIH-1, neuropatogénesis, neurogénesis, citocinas, embriología. The human immunodeficiency virus type 1 and the developing central nervous systemCurrently, at least 42 million people are infected worldwide with the human immunodeficiency virus type 1 (HIV-1). Of these, 3.2 million are children infected, in 90% of the cases, through vertical transmission. In Colombia, approximately 200,000 persons have been infected since the beginning of the pandemic, with an increasing trend in the seroprevalence among pregnant women. Although HIV-1 is basically lymphotropic, its capacity to invade the central nervous system (CNS) is well known, generating multiple neurological alterations, especially prominent in children, with encephalopathy being the most prevalent. Classically, two types of neurological disorders are recognized in children, consisting of early and late encephalopathies, each with differing clinical and immunological characteristics. HIV-1 infection of the CNS is limited to macrophages, microglia and astrocytes in a restricted manner. In patients with acquired immunodeficiency virus (AIDS), neurons are rarely infected, suggesting that cellular and viral soluble factors, are responsible for the neuronal damage. The conclusion is that the CNS in earlier stages of development is especially susceptible to HIV-1 infection. The epidemiological trends predict that these types of clinical...

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Effects of Pediatric HIV Infection and Prenatal Drug Exposure on Mental and Psychomotor Development

Cited by 36 publications

References 0 publications

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Developmental delay in HIV-exposed infants in Harare, Zimbabwe

Neurodevelopmental Outcomes of Ugandan Infants With Human Immunodeficiency Virus Type 1 Infection

El virus de la inmunodeficiencia humana tipo 1 y el sistema nervioso central en desarrollo.

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