Longitudinal Intellectual Assessment of Children With HIV Infection

Franklin, Suzie; Lim, Hyun J.; Rennie, Kimberly M.; Eastwood, Dan; Cuene, Barbara E.; Havens, Peter L.

doi:10.1007/s10880-005-7823-z

Cited by 14 publications

(11 citation statements)

References 20 publications

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“…In adjusted analyses, initially observed differences between PHIV and HEU youth, including numerical abilities, were explained by factors other than HIV. Consistent with Franklin et al, 16 PHIV and HEU youth do not demonstrate any profound cognitive or achievement deficits, and based on gross comparison of these global measures, appear to be achieving generally commensurate with observed IQ, which is encouraging regarding the developmental impact of HIV and HIV exposure.…”

Section: Discussionsupporting

confidence: 82%

“…14–15 In a small sample of pre-adolescents with HIV (n=25), achievement was commensurate with Intelligence Quotient (IQ), whereby both IQ and achievement trended in the Low Average to Average range over 10 years, contrary to the predicted decline in academic achievement over time. 16–17 Other studies reported youth with HIV performed below average on tests of reading, reading comprehension, mathematical reasoning, 13,14 and receptive (picture) vocabulary, and performed more poorly than their seronegative peers. 18 Yet, early reports on achievement in seronegative peers revealed below average performance in reading, spelling, and mathematics, 14 suggesting academic deficits may be attributable to environmental, sociodemographic and/or factors other than HIV exposure.…”

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confidence: 99%

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Discordance of Cognitive and Academic Achievement Outcomes in Youth With Perinatal HIV Exposure

Garvie

Zeldow

Malee

et al. 2014

Pediatric Infectious Disease Journal

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Background To evaluate achievement in youth with perinatally acquired HIV (PHIV) compared to HIV-exposed uninfected peers (HEU), and to examine differential effects of HIV on cognition-achievement concordance. Methods Cognition and achievement were assessed using standardized measures. IQ-derived predicted achievement scores were subtracted from observed achievement scores to calculate discrepancy values. Linear regression models were used to compare achievement discrepancies between PHIV and HEU, adjusting for demographic covariates. Results Participants: 295 PHIV and 167 HEU youth; 71% black, 48% male, mean age 13.1 and 11.3 years, respectively. PHIV youth were relatively healthy (mean CD4%, 32%; viral load ≤400 copies/mL, 72%). PHIV and HEU youth had cognitive and achievement scores significantly below population norm means (p<0.001), but did not differ in cognition (mean FSIQ=86.7 vs. 89.4, respectively). In unadjusted models, HEU outperformed PHIV youth on Total Achievement (TA; mean=89.2 vs. 86.0, p=0.04) and Numerical Operations (NO; mean=88.8 vs. 82.9, p<0.001); no differences remained after adjustment. Mean observed-predicted achievement discrepancies reflected “underachievement”. History of encephalopathy predicted poorer achievement (p=0.039) and greater underachievement, even after adjustment. PHIV showed greater underachievement than HEU for NO (p<0.001) and TA (p=0.03), but these differences did not persist in adjusted models. Conclusions Both PHIV and HEU youth demonstrated lower achievement than normative samples, and underachieved relative to predicted achievement scores. Observed-predicted achievement discrepancies were associated with prior encephalopathy, older age and other non-HIV factors. PHIV youth with prior encephalopathy had significantly lower achievement and greater underachievement compared to PHIV without encephalopathy and HEU youth, even in adjusted models.

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Section: Discussionsupporting

confidence: 82%

mentioning

confidence: 99%

Discordance of Cognitive and Academic Achievement Outcomes in Youth With Perinatal HIV Exposure

Garvie

Zeldow

Malee

et al. 2014

Pediatric Infectious Disease Journal

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“…There were a few studies who reported findings for processing speed (4/15) 4,21,28,30 and visual memory (3/15) 25,28,32 . The remainder of the studies only reported findings for overall or global cognition 22,24,31,33,34,38 . See Appendix B for further details on the qualitative analysis for all of the included studies.…”

Section: Resultsmentioning

confidence: 99%

HIV-Associated Cognitive Impairment in Perinatally Infected Children: A Meta-analysis

Phillips¹,

Amos²,

Kuo

et al. 2016

Pediatrics

114

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Context 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. Objective To systematically review and meta-analyse the degree of cognitive impairment, and the specific cognitive domains affected, in children and adolescents with perinatally acquired HIV-infection. Data Sources We systematically searched 5 electronic bibliographic databases namely: PubMed, PsychINFO, Academic Search Premier, Scopus, and WorldCat, using a search protocol specifically designed for this study. Study Selection Studies were selected on the basis of set a priori eligibility criteria. Titles, abstracts and full texts were assessed by two independent reviewers Data Extraction Data from included studies were extracted into Microsoft Excel by two independent reviewers. Results 22 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. Limitations 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. Conclusions The evidence supports an association between HIV-infection in children and adolescents, and cognitive impairment in the domains of executive function and processing speed, with effect size estimates also providing some support for deficits in visual memory and visual spatial ability.

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“…Since the advent of combination antiretroviral therapy (cART), PHIV has evolved from a fatal disease to a chronic disease as children perinatally infected with HIV-1 survive into adulthood (Smith and Wilkins 2015; Crowell et al 2014). Chronic neurological impairment is still commonly reported in children perinatally infected with PHIV despite the advancements resulting from cART (Franklin et al 2005; Paramesparan et al 2010). Given the prevalence of PHIV, understanding early developmental alterations may provide an innovative clinical diagnostic screening tool for neurological impairment in HIV-1 seropositive children.…”

Section: Introductionmentioning

confidence: 99%

“…High rates of chronic neurological impairment, including neurodevelopmental delays, continue to be reported in HIV-1 seropositive children (Franklin et al 2005; Paramesparan et al 2010; review, Van Rie et al 2007). Neurological assessments, including the Bayley Scales of Infant Development and Wechsler Intelligence Scale for Children-Revised, have previously been used to assess the effect of pediatric HIV-1 on neurodevelopment (Blanchette et al 2002; Lindsey et al 2007; Van Rie et al 2008; Walker et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Selective developmental alterations in The HIV-1 transgenic rat: Opportunities for diagnosis of pediatric HIV-1

2016

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Since the advent of combination antiretroviral therapy (cART), pediatric HIV-1 (PHIV) has evolved from a fatal disease to a chronic disease as children perinatally infected with HIV-1 survive into adulthood. The HIV-1 transgenic (Tg) rat, which expresses 7 of the 9 HIV-1 genes constitutively throughout development, was used to model the early development of chronic neurological impairment in PHIV. Male and female Fischer HIV-1 Tg and F344N control rats, sampled from 35 litters, were repeatedly assessed during early development using multiple experimental paradigms, including somatic growth, locomotor activity, cross-modal prepulse inhibition (PPI) and gap-prepulse inhibition (gap-PPI). Later eye opening was observed in HIV-1 Tg animals relative to controls. HIV-1 Tg animals exhibited a shift in the development of locomotor activity implicating alterations in the maturation of the forebrain cholinergic inhibitory system. Alterations in the development of PPI and perceptual sharpening were observed in both auditory and visual PPI as indexed by a relative insensitivity to the dimension of time (ms for ISI; days of age for perceptual sharpening) as a function of the HIV-1 transgene. Presence of the HIV-1 transgene was diagnosed with 97.1% accuracy using auditory and visual PPI measurements from PD 17 and 21. Early selective developmental alterations observed in the HIV-1 Tg rats provide an opportunity for the development of a point-of-care screening tool, which would permit for early diagnosis of PHIV and improve the long-term outcome for children perinatally infected with HIV-1.

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Longitudinal Intellectual Assessment of Children With HIV Infection

Cited by 14 publications

References 20 publications

Discordance of Cognitive and Academic Achievement Outcomes in Youth With Perinatal HIV Exposure

Discordance of Cognitive and Academic Achievement Outcomes in Youth With Perinatal HIV Exposure

HIV-Associated Cognitive Impairment in Perinatally Infected Children: A Meta-analysis

Selective developmental alterations in The HIV-1 transgenic rat: Opportunities for diagnosis of pediatric HIV-1

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