title: Cognitive Function in Young Persons With and Without Perinatal HIV in the AALPHI Cohort in England: Role of Non-HIV-Related Factors.
abstract: BACKGROUND
  There is limited evidence about the cognitive performance of older adolescents with perinatally acquired human immunodeficiency virus (HIV) compared with HIV-negative (HIV-) adolescents.
  
  
  METHODS
  A total of 296 perinatally HIV-infected (PHIV+) and 97 HIV- adolescents (aged 12-21 and 13-23 years, respectively) completed 12 tests covering 6 cognitive domains. The HIV- participants had PHIV+ siblings and/or an HIV-infected mother. Domain-specific and overall (NPZ-6) z scores were calculated for PHIV+ participants, with or without Centers for Disease Control and Prevention (CDC) stage C disease, and HIV- participants. Linear regression was performed to explore predictors of NPZ-6.
  
  
  RESULTS
  One hundred twenty-five (42%) of the PHIV+ and 31 (32%) of the HIV- participants were male; 251 (85%) and 69 (71%), respectively, were black African; and their median ages (interquartile range) were 16 (15-18) and 16 (14-18) years, respectively. In PHIV+ participants, 247 (86%) were receiving antiretroviral therapy, and 76 (26%) had a previous CDC C diagnosis. The mean (standard deviation) NPZ-6 score was -0.81 (0.99) in PHIV+ participants with a CDC C diagnosis (PHIV+/C), -0.45 (0.80) in those without a CDC C diagnosis (PHIV+/no C), and -0.32 (0.76) in HIV- participants (P < .001). After adjustment, there was no difference in NPZ-6 scores between PHIV+/no C and HIV- participants (adjusted coefficient, -0.01; 95% confidence interval, -.22 to .20). PHIV+/C participants scored below the HIV- group (adjusted coefficient, -0.44; -.70 to -.19). Older age predicted higher NPZ-6 scores, and black African ethnicity and worse depression predicted lower NPZ-6 scores. In a sensitivity analysis including PHIV+ participants only, no HIV-related factors apart from a CDC C diagnosis were associated with NPZ-6 scores.
  
  
  CONCLUSIONS
  Cognitive performance was similar between PHIV+/no C and HIV- participants and indicated relatively mild impairment compared with normative data. The true impact on day-to-day functioning needs further investigation.
authors: MRC Clinical Trials Unit, University College London.
authors: Ali
authors: A
authors: Judd
authors: MRC Clinical Trials Unit, University College London.
authors: Marthe
authors: M
authors: Le Prevost
authors: Imperial College Healthcare NHS Trust, London.
authors: Diane
authors: D
authors: Melvin
authors: MRC Clinical Trials Unit, University College London.
authors: Alejandro
authors: A
authors: Arenas-Pinto
authors: MRC Clinical Trials Unit, University College London.
authors: Francesca
authors: F
authors: Parrott
authors: Imperial College London, United Kingdom.
authors: Alan
authors: A
authors: Winston
authors: Imperial College Healthcare NHS Trust, London.
authors: Caroline
authors: C
authors: Foster
authors: MRC Clinical Trials Unit, University College London.
authors: Kate
authors: K
authors: Sturgeon
authors: MRC Clinical Trials Unit, University College London.
authors: Katie
authors: K
authors: Rowson
authors: MRC Clinical Trials Unit, University College London.
authors: Di M
authors: DM
authors: Gibb
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D044383:Black People; D002648:Child; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology; D015331:Cohort Studies; D004739:England / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D012307:Risk Factors; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; adolescents; cognitive; perinatal; young people