Associations of Memory and Executive Functioning With Academic and Adaptive Functioning Among Youth With Perinatal HIV Exposure and/or Infection

Sirois, Patricia A.; Chernoff, Miriam; Malee, Kathleen; Garvie, Patricia A.; Harris, Lynnette; Williams, Paige L.; Woods, Steven Paul; Nozyce, Molly; Kammerer, Betsy; Yildirim, Cenk; Nichols, Sharon L.

doi:10.1093/jpids/piw046

Cited by 26 publications

(27 citation statements)

References 32 publications

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“…2 Our results are similar to other studies of youth with PHIV and PHEU youth in that they reveal generally low-average to average functioning across multiple memory and EF tasks, with increased risk observed among youth with histories of CDC Class C diagnoses. 37, 39–40 The results are encouraging in that they reveal no significant group differences or declines in performance among youth with PHIV and PHEU during two years of follow-up.…”

Section: Discussionsupporting

confidence: 87%

Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning

Malee

Chernoff

Sirois

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Little is known regarding effects of perinatally-acquired HIV infection (PHIV) on longitudinal change in memory and executive functioning (EF) during adolescence, despite the importance of these skills for independence in adulthood. Methods PHIV (n=144) and perinatally HIV-exposed uninfected youth (PHEU, n=79), ages 12–17, completed standardized tests of memory and EF at baseline and two years later. Changes from baseline for each memory and EF outcome were compared between PHEU and PHIV youth with (PHIV/C, n=39) and without (PHIV/non-C, n=105) history of CDC Class C (AIDS-defining) diagnoses. Among PHIV youth, associations of baseline and past disease severity with memory and EF performance at follow-up were evaluated using adjusted linear regression models. Results Participants were primarily black (79%); 16% were Hispanic; 55% were female. Mean memory and EF scores at follow-up generally fell in the low-average to average range. Pairwise comparison of adjusted mean change from baseline to follow-up revealed significantly greater change for PHIV/non-C compared to PHEU youth in only one verbal recognition task, with a difference in mean changes for PHIV/non-C versus PHEU of −0.99 (95%CI: −1.80, −0.19; p=0.02). Among youth with PHIV, better immunologic status at baseline was positively associated with follow-up measures of verbal recall and recognition and cognitive inhibition/flexibility. Past AIDS-defining diagnoses and higher peak viral load were associated with lower performance across multiple EF tasks at follow-up. Conclusions Youth with PHIV demonstrated stable memory and EF during a two-year period of adolescence, allowing cautious optimism regarding long-term outcomes.

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Section: Discussionsupporting

confidence: 87%

Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning

Malee

Chernoff

Sirois

et al. 2017

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

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“…Our results align with those of several previous studies in sub-Saharan Africa (Boivin et al, 2018;Chaudhury et al, 2017), Asia (Jahanshad et al, 2015), and the United States (Nichols et al, 2016a(Nichols et al, , 2016aRice et al, 2013;Sirois et al, 2016). However, the current literature on cognitive development in CHEU contains disparate results.…”

Section: Discussionsupporting

confidence: 91%

Cognitive and Language Development at Age 4–6 Years in Children HIV‐Exposed But Uninfected Compared to Those HIV‐Unexposed and to Children Living With HIV

Gruver

Kvalsvig

Knox

et al. 2020

New Directions for Child and Adolescent Development

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Perinatal HIV infection is associated with delayed neurocognitive development, but less is known about children perinatally HIV‐exposed but uninfected (CHEU). We compared cognitive and language outcomes in 4–6‐year old CHEU versus children HIV‐unexposed and uninfected (CHUU) and children living with HIV (CLHIV). We enrolled 1,581 children (77% of the child population) in five communities in KwaZulu‐Natal, South Africa. Children completed: Grover‐Counter Scale of cognitive development, sub‐scales of the Kaufman Assessment Battery for Children, Reynell Developmental Language Scales. HIV status of children and primary caregivers was determined by repeated rapid tests or report of prior testing. We conducted a cross‐sectional multivariable linear regression on 922 dyads with complete data (257 CHEU, 627 CHUU, 38 CLHIV). On all outcome measures, CHEU and CHUU groups had comparable scores; CLHIV scored significantly lower. Emerging global progress toward the elimination of vertical HIV transmission may not only reduce mortality, but also positively impact child development.

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“…More recent clinical studies with newer ART regimens have not found such deficits in young children . Fewer data are available about specific cognitive functions in older HEU children and adolescents, but studies have found a higher frequency of reading and math impairments in HEU children compared to the general population . While this review does not clearly identify HIV or ART exposure as being associated with deficits in cognition or memory, it does raise concerns regarding cognitive development in HEU.…”

Section: Discussionmentioning

confidence: 74%

In utero exposure to HIV and/or antiretroviral therapy: a systematic review of preclinical and clinical evidence of cognitive outcomes

et al. 2019

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Introducion With the increasing number of children exposed to HIV or antiretroviral therapy in utero, there are concerns that this population may have worse neurodevelopmental outcomes compared to those who are unexposed. The objective of this study was to systematically review the clinical and preclinical literature on the effects of in utero exposure to HIV and/or antiretroviral therapy ( ART ) on neurodevelopment. Methods We systematically searched OVID Medline, Psyc INFO and Embase, as well as the Cochrane Collaborative Database, Google Scholar and bibliographies of pertinent articles. Titles, abstracts, and full texts were assessed independently by two reviewers. Data from included studies were extracted. Results are summarized qualitatively. Results The search yielded 3027 unique titles. Of the 255 critically reviewed full‐text articles, 25 met inclusion criteria for the systematic review. Five articles studied human subjects and looked at brain structure and function. The remaining 20 articles were preclinical studies that mostly focused on behavioural assessments in animal models. The few clinical studies had mixed results. Some clinical studies found no difference in white matter while others noted higher fractional anisotropy and lower mean diffusivity in the brains of HIV ‐exposed uninfected children compared to HIV ‐unexposed uninfected children, correlating with abnormal neurobehavioral scores. Preclinical studies focused primarily on neurobehavioral changes resulting from monotherapy with either zidovudine or lamivudine. Various developmental and behavioural changes were noted in preclinical studies with ART exposure, including decreased grooming, decreased attention, memory deficits and fewer behaviours associated with appropriate social interaction. Conclusions While the existing literature suggests that there may be some neurobehavioral differences associated with HIV and ART exposure, limited data are available to substantially support these claims. More research is needed comparing neurobiological factors between HIV ‐exposed uninfected and HIV ‐unexposed uninfected children and using exposures consistent with current clinical care.

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Associations of Memory and Executive Functioning With Academic and Adaptive Functioning Among Youth With Perinatal HIV Exposure and/or Infection

Cited by 26 publications

References 32 publications

Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning

Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning

Cognitive and Language Development at Age 4–6 Years in Children HIV‐Exposed But Uninfected Compared to Those HIV‐Unexposed and to Children Living With HIV

In utero exposure to HIV and/or antiretroviral therapy: a systematic review of preclinical and clinical evidence of cognitive outcomes

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