The physical and psychological effects of HIV infection and its treatment on perinatally HIV‐infected children

Vreeman, Rachel C.; Scanlon, Michael; McHenry, Megan S.; Nyandiko, Winstone

doi:10.7448/ias.18.7.20258

Cited by 66 publications

(63 citation statements)

References 281 publications

(250 reference statements)

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“…Prior studies of young children with PHIV described lower mean developmental scores including motor scores among PHIV children compared to PHEU . Our results indicate that only PHIV children with later ART initiation, at three to twelve months of age, had significantly lower general developmental score than PHEU at study enrolment.…”

Section: Discussionsupporting

confidence: 37%

Low risk of neurodevelopmental impairment among perinatally acquired HIV‐infected preschool children who received early antiretroviral treatment in Thailand

et al. 2019

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Introduction Antiretroviral therapy ( ART ) is recommended in perinatally HIV‐infect ed ( PHIV ) infants immediately upon diagnosis. We aimed to compare neurodevelopmental outcomes between PHIV children who initiated ART within 12 months of life and perinatally HIV‐ exposed uninfected ( PHEU ) children and to assess neurodevelopmental outcomes by timing of ART . Methods This prospective cohort study included Thai children aged 12 to 56 months who were assessed with the Mullen Scales of Early Learning ( MSEL ) at enrolment and at 48 weeks. Global Developmental Impairment ( GDI ) was defined as Early Learning Composite ( ELC ) ≤ 70 on the MSEL ; typical developmental pattern was defined as ELC > 70 at both visits. Logistic regression was used to compare prevalence of any GDI . Predictors of changing ELC scores were analysed with generalized estimating equations linear regression model. Results From 2016 to 2017, 50 PHIV (twenty‐seven early ART within three months and twenty‐three standard ART within three to twelve months) and 100 PHEU children were enrolled. Median ( IQR ) age at first assessment was 28 (19 to 41) months. PHIV children had lower age‐relevant Z scores for weight, height and head circumference compared to the PHEU group ( p < 0.05). The prevalence of overall GDI was 18% (95% CI 11 to 27) and 32% (95% CI 20 to 47) in PHEU and PHIV children respectively ( p = 0.06). In subgroup analysis, 22% (95% CI 9 to 42) of early ART PHIV children and 44% (95% CI 23 to 66) of standard ART PHIV children had overall GDI . There was a higher rate of GDI in standard ART PHIV children ( p = 0.01), but not in the early ART group ( p = 0.62) when compared with PHEU children. The standard ART PHIV group demonstrated lower typical developmental pattern than both the early ART P...

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Section: Discussionsupporting

confidence: 37%

Low risk of neurodevelopmental impairment among perinatally acquired HIV‐infected preschool children who received early antiretroviral treatment in Thailand

et al. 2019

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“…Das et al [27] reported that among the HIV positive adolescents, 45.3 percent K. Lyambai, L. Mwape suffer from psychiatric-morbid constituting emotional disorder (41.7%), conduct disorder (37.5%), somatization (33.3%) and learning-disorder (29.2%). A review of eight studies by Vreeman et al [28] on the prevalence of psychiatric disorders amongst HIV-infected children and youth (aged 4 to 21 years) using the DSM-IV found high rates of anxiety (24%) and depression (25%).…”

Section: Mental Health Problemsmentioning

confidence: 99%

Mental Health Problems Experienced by HIV Positive Adolescents; A Case of Choma District, Zambia

Lyambai¹,

Mwape²

2018

OJPsych

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Several scholars have reported high mental health problems among adolescents with Human Immunodeficiency Virus (HIV) globally. However, little is known about the mental health of this peculiar group of young people in Choma district. This study aimed to determine the mental health problems experienced by HIV positive adolescents in Choma District. Using the Strengths and Difficulties Questionnaire (SDQ), data were obtained from 103 HIV positive adolescents receiving treatment at Choma General Hospital plus a corresponding number of parents/care givers. Information about mental health services was obtained qualitatively from 10 nurses working in the mental health unit and the Antiretroviral (ART) clinic. The results showed that more than three quarters of the adolescents had mental health problems. Of this number, 57.3 percent had multiple mental health problems: predominantly emotional and peer problems. The study also found a statistically significant relationship between level of stigma and presence of mental health problems (X 2 = 1.123, P = 0.003). In conclusion, the study demonstrated that multiple mental health problems particularly emotional and peer problems are prevalent among adolescents with HIV/AIDS yet are most often undiagnosed. In addition, adolescents with high levels of internalized stigma are more likely to have multiple mental health problems. The findings suggest the need to integrate psychiatric services into routine care of HIV infected adolescents, routine screening for mental health problems and provision of continued professional development among nurses managing these patients.

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“…Children who are infected with HIV/AIDS face life-long risk of related illnesses, and are more likely to experience cognitive and motor development delays, stigma, trauma, and low mood (Vreeman et al 2015, Abubakar et al, 2008; Sherr et al, 2009). Children who have lost one or both parents to HIV are at increased risk of mental health problems (Mutumba et al 2016, Stein et al 2014, Sherr et al 2014), such as internalising disorders and post-traumatic stress (Cluver & Gardner, 2007), and are often living in alternative care situations.…”

Section: Introductionmentioning

confidence: 99%

Interventions to improve psychosocial well-being for children affected by HIV and AIDS: a systematic review

Skeen

Sherr

Croome³

et al. 2017

Vulnerable Children and Youth Studies

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In addition to its contribution to child mortality, HIV/AIDS has a substantial impact on the psychosocial well-being of children across the globe and particularly in sub-Saharan Africa. We conducted a systematic review of the literature in order to identify studies that assess the effectiveness of interventions developed to improve the psychosocial well-being of children affected by HIV/AIDS, published between January 2008 and February 2016. Studies that were eligible for the review included male and/or female children under the age of 18 years of age, who had lost a parent to HIV/AIDS, were living with a parent with HIV/AIDS, or were vulnerable because of other social and economic factors and living in communities of high HIV and AIDS prevalence, including child and caregiver reports. Studies were included if they documented any intervention to improve the psychosocial well-being of children including psychological therapy, psychosocial support and/or care, medical interventions and social interventions, with psychological and/or social factors as outcomes. We identified 17 interventions to improve the psychosocial well-being of children affected by HIV/AIDS. Of these, 16 studies took place in eight different low and middle-income countries (LMIC), of which 6 were in southern and eastern Africa. One study took place in a high-income setting. Of the total, fifteen showed some significant benefits of the intervention, while two showed no difference to psychosocial outcomes as a result of the intervention. The content of interventions, dosage and length of follow up varied substantially between studies. There were few studies on children under seven years and several focused mostly on girls. Efforts to improve evaluation of interventions to improve the psychosocial well-being of children affected by HIV/AIDS have resulted in a number of new studies which met the inclusion criteria for the review. Most studies are specially designed research projects and not evaluations of existing services. We call for increased partnerships between policy-makers, practitioners and researchers in order to design evaluation studies and can feed into the growing evidence base.

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The physical and psychological effects of HIV infection and its treatment on perinatally HIV‐infected children

Cited by 66 publications

References 281 publications

Low risk of neurodevelopmental impairment among perinatally acquired HIV‐infected preschool children who received early antiretroviral treatment in Thailand

Low risk of neurodevelopmental impairment among perinatally acquired HIV‐infected preschool children who received early antiretroviral treatment in Thailand

Mental Health Problems Experienced by HIV Positive Adolescents; A Case of Choma District, Zambia

Interventions to improve psychosocial well-being for children affected by HIV and AIDS: a systematic review

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