Abstract
HIV-1 is known for its complex interaction with the dysregulated immune system and is responsible for the development of neurocognitive deficits and neurodevelopmental delays in pediatric HIV populations. Considering that HIV-1-induced immune dysregulation and its association with neurodevelopmental and neurocognitive impairments in pediatric populations are not well understood, we conducted a scoping review on this topic. The study aimed to systematically review the association of blood and cerebrospinal fluid (CSF) immune markers with neurocognitive deficits and neurodevelopmental delays in pediatric HIV populations. PubMed, Scopus, and Web of Science databases were searched using a search protocol designed specifically for this study. Studies were selected based on a set eligibility criterion. Titles, abstracts, and full texts were assessed by two independent reviewers. Data from the selected studies were extracted and analyzed by two independent reviewers. Seven studies were considered eligible for use in this context, which included four cross-sectional and three longitudinal studies. An average of 130 (±70.61) children living with HIV, 138 (±65.37) children exposed to HIV but uninfected and 90 (±86.66) HIV-negative participants were included across the seven studies. Results indicate that blood and CSF immune markers are associated with neurocognitive development/performance in pediatric HIV populations. Only seven studies met the inclusion criteria, therefore, these limited the number of significant conclusions which could have been made by using such an approach. All considered, the evidence suggests that immune dysregulation, as in the case of adult HIV populations, also has a significant association with neurocognitive performance in pediatric HIV populations.
Highlights
We considered sCD163 to be an important marker for possible future investigation as at least 66% of the studies which included sCD163 in their investigation found it to be associated with neurocognitive impairment in pediatric Human immunodeficiency virus (HIV) populations
Despite the limited number of studies in the field of pediatric HIV research, the main finding from this review suggests that aberrant immune dysregulation is associated with neurocognitive performance in children living with HIV, and children HIV-exposed but uninfected
The findings indicate that sCD163 is an important marker for future investigation as at least 66% of the studies which included sCD163 in their investigation found it to be associated with neurocognitive impairment in pediatric HIV populations. sCD163 is an immune indicator for monocyte activation [39]
Summary
Most children with HIV-1 live into adulthood, and they present a higher risk of neurodevelopmental [2] and neurocognitive deficits [3,4] in later life, as compared to individuals who contracted HIV as adults This is due to the extended exposure to HIV-1 and its related effects, including the dysregulated immune system (higher levels of monocyte activating and inflammatory markers). Studies indicate that even HIV-negative children born from HIV positive mothers present with neurodevelopmental delays and neurocognitive impairment [8–10], and maternal HIV-1 and treatment status, as well as regimen type, may be contributing factors influencing neurodevelopment in these pediatric populations. The latter findings on the influence of in utero ART exposure on neurocognitive performance are contradictory, with some studies reporting a significant association [11], and others no association [10,12,13] of neurodevelopmental delays with ART
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