Abstract
The aim of the study was to assess the presence of cognitive impairments in children and adolescents with vertically transmitted HIV infection and to determine possible relationships with clinical and socio-demographic variables. Fifty children with perinatal HIV infection aged 6-18 years were included in the experimental group (PHIV+). Two sex- and age-matched groups were recruited as reference groups: (1) a PHEU group that included 24 healthy children perinatally HIV-exposed but uninfected, and (2) an HIV-nA group that included 43 healthy children of uninfected parents. CANTAB Research Suite was used to assess cognitive functioning. In comparison with the HIV-nA group, the PHIV+ group scored worse in movement execution, shifting and flexibility of attention, reversal learning and working memory. In comparison with the PHEU group, the PHIV+ group had significantly longer planning time in the memory task. The analysis of results for the 12-18 year-old age group revealed deterioration of cognitive functions in all tests of the PHIV+ children in comparison with the HIV-nA group. A higher logarithm of viral load at the start of the ARV treatment was associated with worse results in the use of feedback, shifting of attention, cognitive flexibility and worse information processing. Results of the research indicate deterioration of executive functioning in the PHIV+ group associated with longer duration of HIV neuroinfection and severity of infection before treatment.
Highlights
IntroductionIn children and adolescents with perinatal HIV (human immunodeficiency virus) infection, cognitive functioning may be affected by fetal factors (HIV infection, medications taken by the mother, drugs, alcohol, malnutrition, and other infections and diseases), HIV course-related factors and environmental factors (cognitive and educational levels of the parents, socioeconomic status, the presence of illness, the experience of loss of a parent, etc.) [1]
In children and adolescents with perinatal HIV infection, cognitive functioning may be affected by fetal factors (HIV infection, medications taken by the mother, drugs, alcohol, malnutrition, and other infections and diseases), HIV course-related factors and environmental factors [1]
Results of the research indicate deterioration of executive functioning in the PHIV+ group associated with longer duration of HIV neuroinfection and severity of infection before treatment
Summary
In children and adolescents with perinatal HIV (human immunodeficiency virus) infection, cognitive functioning may be affected by fetal factors (HIV infection, medications taken by the mother, drugs, alcohol, malnutrition, and other infections and diseases), HIV course-related factors and environmental factors (cognitive and educational levels of the parents, socioeconomic status, the presence of illness, the experience of loss of a parent, etc.) [1]. In the majority of studies on perinatally HIV-infected (PHIV+) subjects, general intellectual functioning tests have typically been used as indicators of neurodevelopmental cognitive deficits. The results of studies carried out in developed countries indicate proper cognitive functioning in PHIV+ children treated with HAART (highly active antiretroviral therapy) and in PHEU (perinatally HIV-exposed but uninfected) children [2, 4,5,6,7,8,9,10]. Some observations confirmed the presence of language [2, 11, 12] and memory deficits, as well as executive functions deficits [2, 8, 9, 13,14,15,16] in PHIV+ children treated with HAART with medications that penetrate the blood-brain barrier. The most commonly described deficits of executive functioning include sequencing and planning [5, 8], response inhibition [8], working memory [5, 6, 8, 13,14,15,16,17] (including visuospatial working memory, VMW [2, 5]), flexibility of attention [2], simple response time [2], and processing speed [2, 6, 13, 15, 18]
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