A Systematic Review of Psychological Functioning of Children Exposed to HIV: Using Evidence to Plan for Tomorrow’s HIV Needs

Sherr, Lorraine; Croome, Natasha; Castaneda, Katherine Parra; Bradshaw, Katie

doi:10.1007/s10461-014-0747-6

Cited by 38 publications

(41 citation statements)

References 33 publications

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“…Recent systematic reviews have documented the consistent concerns regarding cognitive outcomes and HIV exposure [12, 13]. In addition there is a growing evidence base that children who are negative but exposed to HIV in utero also experience delay [4] but the biological and/or social mechanisms of such effects are unclear.…”

Section: Introductionmentioning

confidence: 99%

Could cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi

et al. 2017

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BackgroundSocial protection interventions, including cash grants and care provision have been shown to effectively reduce some negative impacts of the HIV epidemic on adolescents and families. Less is known about the role of social protection on younger HIV affected populations. This study explored the impact of cash grants on children’s cognitive development. Additionally, we examined whether combined cash and care (operationalised as good parenting) was associated with improved cognitive outcomes.MethodsThe sample included 854 children, aged 5 – 15, participating in community-based organisation (CBO) programmes for children affected by HIV in South Africa and Malawi. Data on child cognitive functioning were gathered by a combination of caregiver report and observer administered tests. Primary caregivers also reported on the economic situation of the family, cash receipt into the home, child and household HIV status. Parenting was measured on a 10 item scale with good parenting defined as a score of 8 or above.ResultsAbout half of families received cash (55%, n = 473), only 6% (n = 51) reported good parenting above the cut-off point but no cash, 18% (n = 151) received combined cash support and reported good parenting, and 21% (n = 179) had neither. Findings show that cash receipt was associated with enhanced child cognitive outcomes in a number of domains including verbal working memory, general cognitive functioning, and learning. Furthermore, cash plus good parenting provided an additive effect. Child HIV status had a moderating effect on the association between cash or/plus good parenting and cognitive outcomes. The association between cash and good parenting and child cognitive outcomes remained significant among both HIV positive and negative children, but overall the HIV negative group benefited more.ConclusionsThis study shows the importance of cash transfers and good parenting on cognitive development of young children living in HIV affected environments. Our data clearly indicate that combined provision (cash plus good parenting) have added value.

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Section: Introductionmentioning

confidence: 99%

Could cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi

et al. 2017

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“…[46][47][48] Furthermore, there is growing evidence that HEU children may experience early developmental impairment. Previous reviews have reported some delays in cognitive, language or motor development, [47,49,50] although to a lesser extent than in CLHIV and mainly in low-resource settings. [47] A recent study from SA found motor and cognitive delay, particularly associated with preterm birth, [51] and a study from Zambia reported a later impact on school performance.…”

Section: Early Neurodevelopmentmentioning

confidence: 95%

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa

et al. 2019

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“…As the HIV+ cART population ages, ANI and MNI might progress to more serious cognitive impairment and the pathways involved are similar to those of Alzheimer's Disease 9,10 (e.g., Aβ-oligomers are elevated 11 ). Also, HIV+ children on cART, display reduced IQ and cognition [12][13][14][15][16] and HIV-children, perinatally exposed to cART, experience developmental delays 17 . There is growing concern that cART, itself, may have effects on cognition 18 .…”

Section: Introductionmentioning

confidence: 99%

High-content analysis and Kinetic Image Cytometry identify toxic and epigenotoxic effects of HIV antiretrovirals on human iPSC-neurons and primary neural precursor cells

Smith

Ankam

Farhy

et al. 2020

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Combination antiretroviral therapy (cART) improves life expectancy and lowers the incidence of central nervous system (CNS) opportunistic infections, lymphomas, and HIV-associated dementia in HIV+ people. However, mild-to-moderate HIV-associated neurocognitive disorders (HAND) persist in about 50% of HIV+ people, even when HIV replication is well controlled. In vitro, animal model, and clinical studies suggest that cART neurotoxicity could be a contributing factor to the progression of HAND. In this study, we developed two in vitro model systems using glutamatergic neurons derived from human induced pluripotent stem cells (hiPSC-Gluts) and fetal neural precursor cells (hNPCs) to assay for antiretroviral (ARV) effects on mature and developing neurons, respectively. We tested four ARVs: the nucleoside/nucleotide reverse transcriptase inhibitors tenofovir disproxil fumarate (TDF) and emtricitabine (FTC) and the integrase inhibitors dolutegravir (DTG) and elvitegravir (EVG). DTG, EVG, and TDF decreased hiPSC-Glut viability and neurite length; all four antiretrovirals decreased hiPSC-Glut synapse counts; and DTG and EVG decreased the frequency and magnitude of hiPSC-Glut calcium transients. The magnitude of these neurotoxic effects increased with longer ARV exposure times and with the exposure of hiPSC-Gluts to two or three ARVs simultaneously. These results suggest that certain ARVs could cause HAND by decreasing the survival and function of CNS neurons. In fetal hNPCs, TDF decreased viability and changed the distribution of epigenetic histone modifications, suggesting that this ARV may alter neurogenesis, which could impair cognition in adults and/or CNS development for those exposed to ARV in utero or early childhood. Our study establishes human preclinical neurotoxicity systems that can screen for potential ARV CNS toxicity and develop safer cART regimens.

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A Systematic Review of Psychological Functioning of Children Exposed to HIV: Using Evidence to Plan for Tomorrow’s HIV Needs

Cited by 38 publications

References 33 publications

Could cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi

Could cash and good parenting affect child cognitive development? A cross-sectional study in South Africa and Malawi

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa

High-content analysis and Kinetic Image Cytometry identify toxic and epigenotoxic effects of HIV antiretrovirals on human iPSC-neurons and primary neural precursor cells

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