title: HIV-Associated Cognitive Impairment in Perinatally Infected Children: A Meta-analysis.
abstract: Research shows, conclusively, that perinatal HIV infection has negative effects on cognitive functioning of children and adolescents. However, the extent of these cognitive impairments is unknown. Current literature does not document specific cognitive domains most affected in HIV-infected children and adolescents.
  
  
  
  To systematically review and meta-analyze the degree of cognitive impairment, and the specific cognitive domains affected, in children and adolescents with perinatally acquired HIV infection.
  
  
  
  We systematically searched 5 electronic bibliographic databases, namely: PubMed, PsychINFO, Academic Search Premier, Scopus, and WorldCat, by using a search protocol specifically designed for this study.
  
  
  
  Studies were selected on the basis of set a priori eligibility criteria. Titles, abstracts, and full texts were assessed by 2 independent reviewers.
  
  
  
  Data from included studies were extracted into Microsoft Excel by 2 independent reviewers.
  
  
  
  Twenty-two studies were identified for inclusion in the systematic review and of this, 6 studies were included in the meta-analysis. Results from the meta-analysis indicated that working memory and executive function were the domains most affected by the HIV virus.
  
  
  
  Only 27% of the included studies were suitable to enter into the meta-analysis. There was significant geographic bias in published studies, with only 32% (7/22) of included studies from sub-Saharan Africa.
  
  
  
  The evidence supports an association between HIV infection in children and adolescents and cognitive impairment in the domains of working memory, executive function and processing speed, with effect size estimates also providing some support for deficits in visual memory and visual-spatial ability.
authors.affiliation: Department of Psychiatry and Mental Health and nicole.phillips@uct.ac.za.
authors.forename: Nicole
authors.initials: N
authors.lastname: Phillips
authors.affiliation: Department of Psychiatry and Mental Health and.
authors.forename: Taryn
authors.initials: T
authors.lastname: Amos
authors.affiliation: Department of Psychiatry and Mental Health and.|Department of Behavioral and Social Sciences, Brown University, Providence, Rhode Island; and.
authors.forename: Caroline
authors.initials: C
authors.lastname: Kuo
authors.affiliation: Department of Psychiatry and Mental Health and.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Hoare
authors.affiliation: Department of Psychiatry and Mental Health and.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ipser
authors.affiliation: ACSENT Laboratory, Department of Psychology, University of Cape Town, Cape Town, South Africa.
authors.forename: Kevin G F
authors.initials: KG
authors.lastname: Thomas
authors.affiliation: Department of Psychiatry and Mental Health and.|South African Medical Research Council Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D060825:Cognitive Dysfunction / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D018562:Disease Transmission, Infectious; D056344:Executive Function / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000635:transmission; D006801:Humans; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D009483:Neuropsychological Tests; D011379:Prognosis; D012720:Severity of Illness Index