title: Neurodevelopment in perinatally HIV-infected children: a concern for adolescence.
abstract: Globally, an estimated 3.4 million children are living with HIV, yet little is known about the effects of HIV and antiretroviral treatment (ART) on the developing brain, and the neurodevelopmental and behavioural outcomes of perinatally HIV-infected (PHIV+) adolescents. We reviewed the literature on neurodevelopmental outcomes in PHIV+ children and adolescents, and summarized the current evidence on behaviour, general cognition, specific domains, hearing and language, school performance and physical disabilities due to neurological problems. Evidence suggests that PHIV+ children do not perform as well as controls on general cognitive tests, processing speed and visual-spatial tasks, and are at much higher risk for psychiatric and mental health problems. Children with AIDS-defining diagnoses are particularly at risk for poorer outcomes. A striking finding is the lack of published data specific to the adolescent age group (10-25 years), particularly from resource-constrained countries, which have the highest HIV prevalence. In addition, extreme heterogeneity in terms of timing and source of infection, and antiretroviral experience limits our ability to summarize findings of studies and generalize results to other settings. Due to the complex nature of the developing adolescent brain, environmental influences and variation in access to ART, there is an urgent need for research on the longitudinal trajectory of neurodevelopment among children and adolescents perinatally infected with HIV, especially in high burden resource-constrained settings.
authors.affiliation: Children's Infectious Diseases Clinical Research Unit, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa. BL2@sun.ac.za
authors.forename: Barbara
authors.initials: B
authors.lastname: Laughton
authors.forename: Morna
authors.initials: M
authors.lastname: Cornell
authors.forename: Michael
authors.initials: M
authors.lastname: Boivin
authors.forename: Annelies
authors.initials: A
authors.lastname: Van Rie
mesh_terms: D015526:AIDS Dementia Complex / Q000453:epidemiology* / Q000473:pathology; D000293:Adolescent; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002490:Central Nervous System / Q000187:drug effects; D002648:Child; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000473:pathology
chemical_list: D019380:Anti-HIV Agents
keywords: adolescents; children; executive function; hearing; neurocognitive; neurodevelopment; neurological; perinatally HIV infected