Neurodevelopmental trajectory of HIV-infected children accessing care in Kinshasa, Democratic Republic of Congo.
OBJECTIVE
To assess the effect of HIV care (including highly active antiretroviral therapy if eligible) on neurodevelopment.


METHODS
Prospective cohort study.


METHODS
Motor and mental development of 35 HIV-infected children (aged 18-71 months) was assessed at entry into care and after 6 and 12 months using age-appropriate tools. Developmental trajectory was compared with 35 HIV-uninfected, affected, and 90 control children using linear mixed-effects models. Effects of age (<or= or >29 months) and timing of entry into care (before or after highly active antiretroviral therapy eligibility) were explored in secondary analyses.


RESULTS
At baseline, HIV-infected children had the lowest, control children the highest, and HIV-uninfected affected children intermediate mean developmental scores. After 1 year of care, HIV-infected children achieved mean motor and cognitive scores that were similar to HIV uninfected, affected children although lower compared with control children. Overall, HIV-infected children experienced accelerated motor development but similar gains in cognitive development compared with control children. Exploratory analyses suggest that younger children and those presenting early may experience accelerated greater gains in development.


CONCLUSIONS
HIV-infected children accessing care experience improved motor development, and may, if care is initiated at a young age or an early stage of the disease, also experience gains in cognitive development.
Van Rie
Annelies
A
Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7435, USA. vanrie@email.unc.edu
Dow
Anna
A
Mupuala
Aimee
A
Stewart
Paul
P
D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D015023:Democratic Republic of the Congo; D002658:Developmental Disabilities / Q000503:physiopathology* / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D009043:Motor Activity; D011446:Prospective Studies
D044966:Anti-Retroviral Agents