Effects of highly active antiretroviral therapy (HAART) on psychomotor performance in children with HIV disease.
OBJECTIVE
This study assesses the effects of HAART on psychomotor performance of symptomatic HIV-infected children. It is one of the first studies to look at neurobehavioral functioning in children infected with HIV in resource-limited countries.


METHODS
A longitudinal pilot study of vertically HIV-infected children at the HIV Netherlands Australia Thailand Research Collaboration Center in Bangkok, Thailand.


METHODS
A total of 34 children participated in the study of whom 16 had never received antiretroviral (ARV) therapy and were about to start HAART (Newly treated children), 7 did not receive antiretroviral therapy (Untreated children) and 11 had been treated with HAART for more than one year (HAART experienced children). All children were administered 4 psychomotor tasks at baseline and after 4 months. The Newly treated and the Untreated children were also evaluated after 12 months.


RESULTS
In general, the children performed similarly on all psychomotor tasks at baseline. After 12 months of HAART, there was a significant increase in CD4% in the Newly treated group. Overall, psychomotor performance did not change at the 4-month evaluation in all groups. At the 12-month evaluation psychomotor performance had deteriorated substantially on all tasks in both the Newly treated and the Untreated children.


CONCLUSIONS
There was no significant difference in psychomotor functioning between children newly treated, previously treated and untreated with HAART over the course of one year. Psychomotor performance deteriorated after 12 months of HAART, which provides important indications concerning the lack of benefits of HAART on psychomotor functions in children despite immunologic reconstitution. Further research with larger sample sizes is needed to confirm these findings.
Koekkoek
Sanneke
S
Department of Clinical Neuropsychology, Faculty of Social Sciences, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands. Sanneke_k@hotmail.com
Eggermont
Laura
L
De Sonneville
Leo
L
Jupimai
Thidakat
T
Wicharuk
Saijai
S
Apateerapong
Wichitea
W
Chuenyam
Theshinee
T
Lange
Joep
J
Wit
Ferdinand
F
Pancharoen
Chitsanu
C
Phanuphak
Praphan
P
Ananworanich
Jintanat
J
D000704:Analysis of Variance; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010865:Pilot Projects; D011597:Psychomotor Performance / Q000187:drug effects*; D011930:Reaction Time / Q000187:drug effects; D012044:Regression Analysis; D013997:Time Factors
D019380:Anti-HIV Agents