In utero antiretroviral exposure and sociodemographic characteristics on neurodevelopment of HIV‐exposed uninfected children versus HIV‐unexposed uninfected healthy children in Malawi

Abstract

Background To evaluate mental development index (MDI) and psychomotor development index (PDI) scores of HIV‐exposed uninfected (HEU) children by timing of in utero antiretroviral treatment (ART) initiation (Option B+) and sociodemographic characteristics compared with HIV‐unexposed uninfected (HUU) children in Mzuzu, Malawi. Methods One hundred HEU children and 100 HUU children aged 2–30 months were recruited. The differences in MDI and PDI scores between HEU and HUU children were tested by Student's t test, analysis of variance, Mann–Whitney U test, and logistic regression analysis. Results The differences in MDI and PDI scores might be related to number of children in the family, delivery, place of residence, family income, complementary feeding, father's or mother's occupation, and degree of education. No significant difference in MDI and PDI scores between HEU and HUU children (P = 0.076 and P = 0.407) was found. Among HEU children, ART in the third trimester and beyond produced a lower PDI score compared with ART before pregnancy and in the first or second trimester (P = 0.027). Conclusion The MDI and PDI scores of HEU subgroups with different timing of ART (Option B+) initiation were comparable to those of the HUU group. Early in utero ART initiation was associated with better neurodevelopmental outcomes than ART initiation in the third trimester and beyond.

Vitamin D and Probability of Developmental Disorders among Perinatally HIV-Affected and Unaffected Ugandan Children

“…Specifically, we observed that compared to VDS pre-adolescents, VDD peers had elevated ASD, ADHD, and EBD as well as functional impairment probability scores over 12 months follow-up. Our findings are consistent with previous studies associating VDD in children with increased risk of ASD [1,28,29,45,46] and ADHD [30][31][32][33]. A multinational study of VD supplementation vs. placebo among adults from the United States and Norway found that the VD-supplemented group demonstrated greater stress resiliency [36] and neuropsychological performance over the cold winter months compared to the placebo group.…”