Abstract
ObjectiveObjective assessment of neurocognitive lags in pediatric HIV patients and its correlation with various clinical, social and familial factors.MethodsNinety-eight school-aged children living with HIV (CLHIV) (age 7-18 years) attending regional pediatric HIV clinic were observed for neurocognitive lag using Raven’s Standard Progressive Matrices by the same trained instructor. Sociodemographic data, mode of transmission, clinical staging, CD4 count, highly active antiretroviral therapy (HAART) duration were recorded and analyzed in the well-performing group and under-performing group.Results29.6% of children had definitive neurocognitive lag. The proportion of older children (11-18 years) in the under-performing group was significantly high (P = 0.007). The mean CD4 counts were low in the under-performing group (P = 0.001). Other socioeconomic factors could not be specifically correlated with neurocognitive lag in either of the groups.ConclusionCLHIV has a significant neurocognitive lag, which is accentuated in the upper age group. Findings point toward declining intellectual gains with increasing age in CLHIV.
Highlights
Neurocognitive manifestations are more frequent and more intense in pediatric HIV disease as compared to their adult variants
CNS seeding of virus and progressive neuronal injury is responsible for such severe neurodevelopmental outcomes in children
The influence of factors affecting neurocognitive development in children living with HIV (CLHIV) is likely to be different in the Indian context as against western countries due to different sociocultural factors and policy-related issues, and actual outcomes may be different
Summary
Neurocognitive manifestations are more frequent and more intense in pediatric HIV disease as compared to their adult variants. CNS seeding of virus and progressive neuronal injury is responsible for such severe neurodevelopmental outcomes in children. Overall survival of such children has prolonged with advancements in diagnostic and medical treatment of HIV infection. Neurocognitive lags in situations of improved survivals negatively affect scholastic performance and social integration [1,2]. The influence of factors affecting neurocognitive development in children living with HIV (CLHIV) is likely to be different in the Indian context as against western countries due to different sociocultural factors and policy-related issues, and actual outcomes may be different. Literature is scarce in evaluating neurocognitive function among school-aged CLHIV in the Indian population [3]
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