Le SIDA en Afrique subsaharienne (serveur d'exploration)

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Neuropsychological performance in African children with HIV enrolled in a multi-site anti-retroviral clinical trial.

Identifieur interne : 000855 ( PubMed/Corpus ); précédent : 000854; suivant : 000856

Neuropsychological performance in African children with HIV enrolled in a multi-site anti-retroviral clinical trial.

Auteurs : Michael J. Boivin ; Linda Barlow-Mosha ; Miriam Chernoff ; Barbara Laughton ; Bonnie Zimmer ; Celeste Joyce ; Mutsa Bwakura-Dangarembizi ; Mmule Ratswana ; Nasreen Abrahams ; Lee Fairlie ; Hermien Gous ; Portia Kamthunzi ; Katie Mccarthy ; Itziar Familiar-Lopez ; Patrick Jean-Phillippe ; Joan Coetzee ; Avy Violari ; Mark Cotton ; Paul Palumbo

Source :

RBID : pubmed:29112069

Abstract

Children with HIV infection (HIV+) are at neuropsychological risk, but few studies have evaluated this at multiple sites in low and middle income countries (LMICs). We compared neuropsychological outcomes at enrollment (>5 yrs age) among HIV+, HIV-uninfected perinatally-exposed (HEU), and HIV unexposed (HU) children from 4 sub-Saharan countries.

DOI: 10.1097/QAD.0000000000001683
PubMed: 29112069

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pubmed:29112069

Le document en format XML

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<div type="abstract" xml:lang="en">Children with HIV infection (HIV+) are at neuropsychological risk, but few studies have evaluated this at multiple sites in low and middle income countries (LMICs). We compared neuropsychological outcomes at enrollment (>5 yrs age) among HIV+, HIV-uninfected perinatally-exposed (HEU), and HIV unexposed (HU) children from 4 sub-Saharan countries.</div>
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<AbstractText Label="OBJECTIVE & DESIGN" NlmCategory="OBJECTIVE">Children with HIV infection (HIV+) are at neuropsychological risk, but few studies have evaluated this at multiple sites in low and middle income countries (LMICs). We compared neuropsychological outcomes at enrollment (>5 yrs age) among HIV+, HIV-uninfected perinatally-exposed (HEU), and HIV unexposed (HU) children from 4 sub-Saharan countries.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">IMPAACT P1060 compared Nevirapine (NVP) versus Lopinavir/Ritonavir (LPVr)-based ART in HIV-infected children 6 to 35 months of age. This study (P1104 s) enrolled P1060 children at 5-11 years of age and evaluated their neuropsychological performance over 2 years using the KABC-II, TOVA, BOT-2, and parent-reported BRIEF. Cohorts were compared using GEE least-squares means adjusted for site, child age and gender, and personal and social characteristics for child and caregiver.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">611 (246 HIV+, 183 HEU, 182 HU) of the 615 enrolled at 6 sites (South Africa [3], Zimbabwe, Malawi, Uganda) were available for analysis. Mean age was 7.2 years, 48% male, 69% in school. Unadjusted and adjusted comparisons were consistent. HIV+ children performed significantly worse than HEU and HUU on KABC-II, TOVA, BOT-2 (P < 0.001), but not on the BRIEF. HUU and HEU cohorts were comparable on cognitive outcomes. HIV+ children initiated on ARV treatment before one year of age had significantly better only in BOT-2 total motor proficiency compared to those started after.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Significant cognitive deficits were documented among HIV+ children. Earlier HIV treatment, neuropsychological monitoring and rehabilitative interventions are needed. Subsequent testing for 2 more years will help evaluate how HIV infection and exposure affect the developmental trajectory.</AbstractText>
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