Neuropsychological performance in African children with HIV enrolled in a multisite antiretroviral clinical trial

Abstract

Significant cognitive deficits were documented among HIV+ children at school age, even when started on ART at an early age. Earlier HIV treatment, neuropsychological monitoring, and rehabilitative interventions are all needed. Subsequent testing for 2 more years will help further evaluate how HIV infection and exposure affect the developmental trajectory.

Validity of Neuropsychological Testing in Young African Children Affected by HIV

“…The purpose was to assess and compare neuropsychological outcomes in three cohorts of young children (5 to < 11 years): HIV-infected (HIV), HIV-exposed but uninfected (HEU) and HIV-unexposed and uninfected (HU) 23 . HIV-infection and exposure was assumed to be perinatal or during breastfeeding.…”

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

“…The KABC-II is designed for children ages 3-18. It was chosen for its demonstrated reliability and crosscultural functionality, including use in other African countries and pilot testing results of the isiZulu language version in South Africa (Kaufman & Kaufman, 2004;Ajayi et al 2017a;Debeaudrap et al, 2018;Boivin et al, 2018Boivin et al, , 2019.…”

“…A number of recent studies have suggested that CHEU may be more likely to experience delay or disability in neurocognitive or language development compared to children who are HIV-unexposed and uninfected (CHUU) (le Roux et al, 2018(le Roux et al, , 2019McHenry et al, 2018;Mukherjee, Devamare, Seth, & Sapra, 2019;Wedderburn et al, 2019;Wu et al, 2018). However, conflicting evidence from methodologically similar studies indicates that developmental scores among CHEU do not differ from those of CHUU (McHenry et al, 2018;Boivin et al, 2018;Desmonde, Goetghebuer, Thorne, & Leroy, 2018;Springer et al, 2018Springer et al, , 2019. Many of the studies to date have been limited by small sample size, differing recruitment and eligibility criteria for the CHEU, CHUU, and CLHIV groups, and/or lack of adjustment for potentially confounding variables, such as household food insecurity or lower education.…”

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa

“…[44,45] Since the introduction of paediatric ART, studies have continued to document neurodevelopmental impairment. [46][47][48] Furthermore, there is growing evidence that HEU children may experience early developmental impairment. Previous reviews have reported some delays in cognitive, language or motor development, [47,49,50] although to a lesser extent than in CLHIV and mainly in low-resource settings.…”

“…[46][47][48] Furthermore, there is growing evidence that HEU children may experience early developmental impairment. Previous reviews have reported some delays in cognitive, language or motor development, [47,49,50] although to a lesser extent than in CLHIV and mainly in low-resource settings. [47] A recent study from SA found motor and cognitive delay, particularly associated with preterm birth, [51] and a study from Zambia reported a later impact on school performance.…”