title: Executive Functioning in Children and Adolescents With Perinatal HIV Infection and Perinatal HIV Exposure.
abstract: BACKGROUND
  Executive functions (EFs) are critical for management of life activities, but few studies have evaluated EFs in children and adolescents with perinatally acquired HIV (PHIV), who are at risk for problems in academics, behavior, and medication adherence. We compared EFs in youth with PHIV and in perinatally HIV-exposed but uninfected (PHEU) youth.
  
  
  METHODS
  Four Delis-Kaplan Executive Function System (D-KEFS) subtests were administered to 173 youth with PHIV and 85 PHEU youth, aged 9 to <19 years, who were enrolled in the Pediatric HIV/AIDS Cohort Study (PHACS) Memory and Executive Functioning Study. Youth with PHIV, with or without history of a Centers for Disease Control and Prevention Class C (AIDS-defining) condition (PHIV/C [n = 45] and PHIV/non-C [n = 128], respectively), were compared with each other and with PHEU youth. Among youth with PHIV, associations with measures of current and past disease severity were evaluated using adjusted linear regression models.
  
  
  RESULTS
  The PHIV/C group (mean age, 15.5 years), compared with the PHIV/non-C and PHEU groups (mean ages, 14.5 and 12.9 years, respectively), were significantly slower on the Inhibition and Color Naming/Reading Combined conditions of the Color-Word Interference subtest and made more errors on Inhibition; differences between the PHIV/C and PHEU groups persisted in adjusted models. No differences in adjusted means for fluency or problem-solving were found. The PHIV/non-C and PHEU groups did not differ on any measure. Associations of specific EF measures with HIV RNA viral load, CD4-positive T-lymphocyte percentage, and age at greatest disease severity were observed.
  
  
  CONCLUSIONS
  Youth with PHIV and previous AIDS-defining conditions performed more poorly on some EF measures. Relationships of EF development with the degree and timing of disease severity require further study. Implications for long-term outcomes and interventions are important avenues for follow-up.
authors.affiliation: Department of Neurosciences, University of California, San Diego, La Jolla.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Nichols
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Chernoff
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Malee
authors.affiliation: Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Sirois
authors.affiliation: Department of Psychology, University of Houston, Texas.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Woods
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
authors.affiliation: Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
authors.forename: Cenk
authors.initials: C
authors.lastname: Yildirim
authors.affiliation: Department of Psychiatry, University of California, San Diego, La Jolla.
authors.forename: Dean
authors.initials: D
authors.lastname: Delis
authors.affiliation: Department of Psychiatry, Boston Children's Hospital, Massachusetts.
authors.forename: Betsy
authors.initials: B
authors.lastname: Kammerer
mesh_terms: D000293:Adolescent; D002648:Child; D056344:Executive Function; D005260:Female; D015658:HIV Infections / Q000503:physiopathology* / Q000523:psychology* / Q000635:transmission; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009483:Neuropsychological Tests
keywords: children; executive functions; perinatal HIV; youth