title: Neurodevelopmental outcomes in HIV-exposed-uninfected children versus those not exposed to HIV.
abstract: Human immunodeficiency virus (HIV)-negative children born to HIV-infected mothers may exhibit differences in neurodevelopment (ND) compared to age- and gender-matched controls whose lives have not been affected by HIV. This could occur due to exposure to HIV and antiretroviral agents in utero and perinatally, or differences in the environment in which they grow up. This study assessed neurodevelopmental outcomes in HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) children enrolled as controls in a multicenter ND study from Thailand and Cambodia. One hundred sixty HEU and 167 HUU children completed a neurodevelopmental assessment using the Beery Visual Motor Integration (VMI) test, Color Trails, Perdue Pegboard, and Child Behavior Checklist (CBCL). Thai children (n = 202) also completed the Wechsler Intelligence Scale (IQ) and Stanford-Binet II memory tests. In analyses adjusted for caregiver education, parent as caregiver, household income, age, and ethnicity, statistically significant lower scores were seen on verbal IQ (VIQ), full-scale IQ (FSIQ), and Binet Bead Memory among HEU compared to HUU. The mean (95% CI) differences were -6.13 (-10.3 to -1.96), p = 0.004; -4.57 (-8.80 to -0.35), p = 0.03; and -3.72 (-6.57 to -0.88), p = 0.01 for VIQ, FSIQ, and Binet Bead Memory, respectively. We observed no significant differences in performance IQ, other Binet memory domains, Color Trail, Perdue Pegboard, Beery VMI, or CBCL test scores. We conclude that HEU children evidence reductions in some neurodevelopmental outcomes compared to HUU; however, these differences are small and it remains unclear to what extent they have immediate and long-term clinical significance.
authors.affiliation: a HIV-NAT , The Thai Red Cross AIDS Research Centre , Bangkok , Thailand.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kerr
authors.forename: Thanyawee
authors.initials: T
authors.lastname: Puthanakit
authors.forename: Ung
authors.initials: U
authors.lastname: Vibol
authors.forename: Linda
authors.initials: L
authors.lastname: Aurpibul
authors.forename: Sophan
authors.initials: S
authors.lastname: Vonthanak
authors.forename: Pope
authors.initials: P
authors.lastname: Kosalaraksa
authors.forename: Suparat
authors.initials: S
authors.lastname: Kanjanavanit
authors.forename: Rawiwan
authors.initials: R
authors.lastname: Hansudewechakul
authors.forename: Jurai
authors.initials: J
authors.lastname: Wongsawat
authors.forename: Wicharn
authors.initials: W
authors.lastname: Luesomboon
authors.forename: Kattiya
authors.initials: K
authors.lastname: Ratanadilok
authors.forename: Wasana
authors.initials: W
authors.lastname: Prasitsuebsai
authors.forename: Kanchana
authors.initials: K
authors.lastname: Pruksakaew
authors.forename: Jasper
authors.initials: J
authors.lastname: van der Lugt
authors.forename: Robert
authors.initials: R
authors.lastname: Paul
authors.forename: Jintanat
authors.initials: J
authors.lastname: Ananworanich
authors.forename: Victor
authors.initials: V
authors.lastname: Valcour
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D002160:Cambodia / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition / Q000187:drug effects; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D007361:Intelligence Tests / Q000706:statistics & numerical data*; D008297:Male; D009422:Nervous System Diseases / Q000139:chemically induced*; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology; D013785:Thailand / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; children; neurodevelopment; resource-limited setting