Neuropsychological performance in African children with HIV enrolled in a multisite antiretroviral clinical trial

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

doi:10.1097/qad.0000000000001683

Cited by 68 publications

(63 citation statements)

References 45 publications

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“…The purpose was to assess and compare neuropsychological outcomes in three cohorts of young children (5 to < 11 years): HIV-infected (HIV), HIV-exposed but uninfected (HEU) and HIV-unexposed and uninfected (HU) 23 . HIV-infection and exposure was assumed to be perinatal or during breastfeeding.…”

Section: Methodsmentioning

confidence: 99%

Validity of Neuropsychological Testing in Young African Children Affected by HIV

Chernoff

Laughton²,

Ratswana

et al. 2018

J Pediatr Infect Dis

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Introduction Western-constructed neuropsychological tests have been used in low and middle income countries to assess the impact of HIV/AIDS and other chronic illnesses. We explore using such instruments cross-culturally in a sub-Saharan Africa setting. Methods IMPAACT P1104S was a two-year observational study carried out at six clinical sites (South Africa- 3 sites, Malawi, Uganda and Zimbabwe) to assess and compare neuropsychological outcomes in three cohorts of children 5–11 years of age: HIV-infected (HIV), HIV-exposed but uninfected (HEU) and HIV unexposed and uninfected (HU). Descriptive statistics compared socio-demographic characteristics among children at sites. Instruments included the KABC-II cognitive ability, TOVA attention/impulsivity, BOT-2 motor proficiency tests, and BRIEF executive function problems. Test characteristics were assessed using intraclass and Spearman non-parametric correlations, linear regression and principal factor analyses. Results Of the 611 participants, 50% were male and mean age ranged from 6.6 to 8 years. In Malawi, Uganda and Zimbabwe, substantial proportions of families lived in rural settings in contrast to the South African sites. Intraclass correlation coefficients between weeks 0 and 48 were highest for the KABC scores, ranging between 0.42 to 0.71.Correlations among similar test domains were low to moderate but significant, with positive correlation between KABC Sequential and TOVA scores and negative correlation between BRIEF and KABC scores. TOVA response time scores correlated negatively with the BOT-2 Total points score. Strong and significant associations between individual measures of growth, disability and development with all test scores were observed. Performance-based measures were markedly lower for HIV compared to HEU and HU participants, even after controlling for age, sex and site. Factor analyses confirmed the underlying theoretical structure of the KABC scaled item scores. Conclusion The KABC, TOVA, BRIEF and BOT-2 were valid and reliable tools for assessing the neuropsychological impact of HIV in four sub-Saharan African countries.

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Section: Methodsmentioning

confidence: 99%

Validity of Neuropsychological Testing in Young African Children Affected by HIV

Chernoff

Laughton²,

Ratswana

et al. 2018

J Pediatr Infect Dis

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“…The KABC-II is designed for children ages 3-18. It was chosen for its demonstrated reliability and crosscultural functionality, including use in other African countries and pilot testing results of the isiZulu language version in South Africa (Kaufman & Kaufman, 2004;Ajayi et al 2017a;Debeaudrap et al, 2018;Boivin et al, 2018Boivin et al, , 2019.…”

Section: Methodsmentioning

confidence: 99%

“…A number of recent studies have suggested that CHEU may be more likely to experience delay or disability in neurocognitive or language development compared to children who are HIV-unexposed and uninfected (CHUU) (le Roux et al, 2018(le Roux et al, , 2019McHenry et al, 2018;Mukherjee, Devamare, Seth, & Sapra, 2019;Wedderburn et al, 2019;Wu et al, 2018). However, conflicting evidence from methodologically similar studies indicates that developmental scores among CHEU do not differ from those of CHUU (McHenry et al, 2018;Boivin et al, 2018;Desmonde, Goetghebuer, Thorne, & Leroy, 2018;Springer et al, 2018Springer et al, , 2019. Many of the studies to date have been limited by small sample size, differing recruitment and eligibility criteria for the CHEU, CHUU, and CLHIV groups, and/or lack of adjustment for potentially confounding variables, such as household food insecurity or lower education.…”

Section: Introductionmentioning

confidence: 99%

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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“…[44,45] Since the introduction of paediatric ART, studies have continued to document neurodevelopmental impairment. [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.…”

Section: Early Neurodevelopmentmentioning

confidence: 99%

“…[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: 99%

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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Neuropsychological performance in African children with HIV enrolled in a multisite antiretroviral clinical trial

Cited by 68 publications

References 45 publications

Validity of Neuropsychological Testing in Young African Children Affected by HIV

Validity of Neuropsychological Testing in Young African Children Affected by HIV

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

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

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