HIV-positive Children Research Articles

Left ventricular mass and diastolic dysfunction in children infected with the human immunodeficiency virus

Background: Increased left ventricular mass (LVM) and diastolic dysfunction are associated with higher morbidity and mortality among adult patients with human immunodeficiency virus (HIV) infection. Objective: The objective of the following study is to determine the prevalence of increased LVM and diastolic dysfunction in Nigerian children infected with HIV. Methods: Cross-sectional comparative study of LVM and left ventricular (LV) diastolic function of 150 HIV-positive children and controls asymptomatic for cardiac disease. Results: Mean LVM was larger in subjects than controls - 66.5 (95% confidence interval, 63.7-69.3) versus 56.9 (54.1-59.7) g/m 2 respectively - P Conclusion: Increased LVM and diastolic dysfunction are significantly more common in HIV-infected children compared with controls and occur in asymptomatic subjects.

Hearing loss in children with HIV/AIDS

To investigate the occurrence of hearing loss in children with HIV and its association with viral load, opportunistic diseases, and antiretroviral treatment. A cross-sectional study was carried out with 23 HIV-positive children under care at two specialized centers in João Pessoa, Paraíba, Brazil. Their parents or legal guardians responded to a questionnaire, containing data on the clinical situation and the hearing health of the children, who were then submitted to audiological assessment. We complied with the guidelines for human research contained in the CNE (National Education Council) Resolution number 196/1996. The findings were analyzed through descriptive statistics. We observed that lamivudine (3TC) was the antiretroviral drug most used in 17 (94.4%) patients, followed by Kaletra (KAL), administered in 14 (77.8%) patients, d4T in 11 (61.1%) patients, and zidovudine (AZT) in 7 (38.9%) participants. Otitis was the most frequent opportunistic disease, with 11 (61.1%) cases. In the audiometric examination, we observed 39 (84.8%) ears with hearing loss and 7 (15.2%) normal ears. After the immitance testing, we found five (10.9%) normal ears, characterized by type A tympanometric curves. The other 41 (89.1%) ears were revealed as altered, with predominance of type B curves in 67.4% of the cases. There were hearing alterations in children with HIV/AIDS analyzed in this study. Discreet hearing losses were the most occurring. We verified statistically significant associations with the use of antiretroviral therapy and otitis. Therefore, we point out the importance of auditory monitoring and intervention as soon as possible, thus favoring adequate development in language and decreasing possible difficulties in learning and social inclusion.

Systematic review of neuroimaging studies in vertically transmitted HIV positive children and adolescents

One of the most serious consequences of vertical HIV-infection is its impact on the central nervous system (CNS). Although much work has been done to elucidate the complex mechanism of HIV associated neurotoxicity, several questions remain unanswered. The purpose of this review is to summarise what is already known in the field of neuroimaging in vertically acquired HIV, addressing three aims and to highlight possible future directions in using neuroimaging and neurocognitive testing to understand the spectrum of neurocognitive disorders in HIV positve children. Here we aim to address several clinically relevant questions in pediatric neuroHIV, using the current evidence base by conducting a systematic review. We aim to investigate what is known about the relationship between cognitive impairment and central nervous system damage in HIV as seen in neuroimaging studies, and to search for any evidence in the current literature which suggests a spectrum of neuocognitive disorders in vertically infected HIV. Secondly, we aim to enquire whether children with a clinical diagnosis of encephalopathy are clearly distinguishable from HIV positive children without encephalopathy on neuroimaging and neurocognitive testing. Finally aim to investigate what is known about the effect on the CNS of antiretroviral therapy in paediatric HIV. Three separate databases were searched and two investigators systematically evaluated the titles, abstracts, and keywords associated with each individual article to determine those that may have met the inclusion and exclusion criteria. Following this process 11 studies were included in the review. Thus there was limited available data to address the 3 questions posed.

Caregivers’ Intentions to Disclose HIV Diagnosis to Children Living with HIV in South Africa: A Theory-Based Approach

When children know their HIV serostatus, they are more likely to cooperate with steps to manage their health and the risk of transmitting HIV to others. Mounting evidence indicates that caregivers often do not disclose to HIV-positive children that the children are living with HIV, but little is known about the modifiable determinants of pediatric HIV disclosure. The present study examined theory-of-planned-behavior predictors of the intention to disclose to children their HIV diagnosis. The participants were 100 caregivers of HIV-positive children in Eastern Cape Province, South Africa. Proportional-odds logistic regression analysis revealed that normative support for disclosure and caregiver-child communication predicted the intention to disclose, whereas behavioral beliefs regarding the consequences of disclosing and self-efficacy to disclose did not. The results suggest that interventions to increase pediatric HIV disclosure in South Africa should help caregivers enlist support for disclosure among important referents and improve communication with their HIV-infected children.

Does a significant reduction in malaria risk make lopinavir/ritonavir-based ART cost-effective for children with HIV in co-endemic, low-resource settings?

HIV infection and malaria co-infection is not uncommon among children in co-endemic regions, and evidence suggests that HIV is a risk factor for severe malaria among children. HIV protease inhibitors (PIs) are highly effective in pediatric HIV treatment regimens, however, their effectiveness against malaria has been mixed, with some PIs demonstrating in vitro activity against Plasmodium falciparum. Recent findings suggest lopinavir/ritonavir (LPV/r)-based treatment regimens reduce the incidence of malaria infection by over 40% in pediatric HIV patients compared to non-nucleoside reverse transcriptase inhibitor (NNRTI)-based regimens. We assessed whether a significant reduction in malaria risk makes LPV/r-based ART regimens cost-effective compared to NNRTI-based regimens in co-endemic, low-resource settings. We modeled the difference in unit cost per disability adjusted life year (DALY) gained among two theoretical groups of HIV+ children under 5 years old receiving ART in a resource-limited setting co-endemic for malaria. The first group received standard NNRTI-based antiretrovirals, the second group received a standard regimen containing LPV/r. We used recent cohort data for the incidence reduction for malaria. Drug costs were taken from the 2011 Clinton Health Access Initiative Antiretroviral (ARV) ceiling price list. DALYs for HIV and malaria were derived from WHO estimates. Our model suggests a unit cost of US$147 per DALY gained for the LPV/r-based group compared to US$37 per DALY gained for the NNRTI-based group. In HIV and malaria co-endemic settings, considerations of PI cost effectiveness incorporating known reductions in malaria mortality suggest a nominal increase in DALYs gained for PIs over NNRTI-based regimens for HIV positive children under five on ART. Our analysis was based on several assumptions due to lack of sound data on malaria and HIV DALY attribution among pediatric populations. Further study in this area is required.

Parotid Gland Enlargement in Pediatric HIV Population

To establish the significance of parotid enlargement, state frequency, cytological features and effect of antiretroviral therapy (ART) on parotid enlargement among a pediatric HIV population. A 6 month cross sectional survey that utilised clinical features, serial immunological indices and fine needle aspiration cytology. 287 HIV positive children were seen at special paediatric clinic of the University College Hospital, Ibadan, Nigeria, 114 (39.7%) had oral features and among these 24 (8.4%) had parotid involvement comprising of 10 males and 14 females. The overall mean age was 43.4 + 39.7 months compared with 59.6 + 36.5 months in the parotid enlargement group (p = 0.03). Mean ages of parotid enlargement and non enlargement group was significantly different (p = 0.03). The mode of transmission was vertical in (91.7%), 87.5% was bilateral (87.5%) and (75%) presented as a syndrome state with generalised lymphadenopathy. The predominant cytology was lymphoid hyperplasia (62.5%). ART resulted in marked clinical reduction in all the cases and statistically significant improvement in serum indices of CD4 count, CD4% and viral load (p = 0.001, 0.000 & 0.009 respectively). HIV positive children often present with bilateral parotid enlargement and the syndrome state with classical clinical and cytological features of lymphoid hyperplasia predominated. ART resulted in satisfactory reduction of the swellings in most of the cases with no need for further intervention.

Vaccination of HIV positive children... a genuine challenge

Methods During 01 January 2012 – 01 September 2013, in the Pediatric and Adolescents Immunosuppression Department of the National Institute for Infectious Diseases “Prof. Dr. Matei Bals” we performed an analysis of the immunizations in children perinatally exposed to HIV, aged 0-18 months. Data from medical records and vaccination history refer to the vaccination share and track, namely from the maternity to the general practitioner. A major setback is parents’ reluctance in accessing medical services. Most of them expose various reasons for avoiding contact with the medical staff, so that most children do not benefit from prevention through vaccination.

Children With Cancer and HIV Infection

Children with HIV and cancer show an excess of non-Hodgkin lymphoma and leiomyosarcoma when compared with children with malignancy but without HIV. This study aimed at: (1) comparing the distribution of various cancers in South African children with malignancies and HIV versus children with malignancies but without HIV and (2) comparing the outcomes after therapy. This is a retrospective comparative study of 84 black children with cancer and HIV, consecutively admitted at Tygerberg Children's Hospital, Cape Town and Universitas Hospital, Bloemfontein, between 1995 and 2010, compared with 570 HIV-negative black children with malignant diseases, consecutively admitted at the 2 hospitals, between 2002 and 2010. Variables studied included age, sex ratio, number of cases of each malignancy, length of follow-up, treatment abandonment, and mortality. The statistical significance was tested with the Student t test and χ test for P≤0.05. Kaplan-Meyer survival curves were constructed. The most frequent cancer was Kaposi sarcoma (39.3%), seen exclusively in children with HIV. Burkitt lymphoma was found more often (20.2%) in the HIV-positive group than in the HIV-negative one (2.8%, P<0.0001). Leiomyosarcoma, described as the second most frequent neoplasm encountered in HIV-positive children, was found in this series only once. The survival figures are much worse in the HIV-positive group: 26.2% versus 47.7% (P<0.0001), mainly due to drug toxicity. Kaposi sarcoma and Burkitt lymphoma occurred more often in children with HIV. These children have a lower tolerance of chemotherapy, even when combined with HAART.

Evolution of parasitic diseases in a collectivity of HIV positive children

Abstract Introduction: Intestinal parasitism represents an important problem of children health. Infestations with protozoa and helmints even have an increased incidence in children they weren’t observed because they were asymptomatic and atypical but with negative influence on their health regardless their immune status. Objective: To evaluate parasitic infections in a collectivity of 38 children HIV+ from Cernavoda city (Hospis “St. Laurence”) over a period of 10 years (2002 - 2012). Material and method: We performed two coproparasitologic examinations (in year 2002 - before antiretroviral treatment and in year 2012 - after 10 years of antiretroviral treatment) by concentration and staining methods and ELISA for Cryptosporidium parvum antigen. Results: In our group of study the median age was 11.65 yrs. in 2002 and 20.6 yrs. in 2012. Sex ratio was M: F = 1:1.2. In year 2002 we found an incidence of parasitic disease of 94.9%, and in year 2012 we found an incidence of 26.31%. In year 2002 we found 6 cases of Giardia intestinalis, 5 cases of Blastocystis hominis, 15 cases of Chilomastix mesnili, 2 cases of Entamoeba coli, 1 case of Ascaris lumbricoides, 2 cases of Hymenolepis nana and 5 cases of poliparasitic disease. In year 2012 we found 4 cases of Giardia intestinalis, 2 cases of Entamoeba coli, 2 cases of Blastocystis hominis and one case of Isospora belli and another one case of Ascaris lumbricoides. Conclusions: After ten years of HAART the incidence of parasitic diseases registered an important decrease from 94.9% to 26.31%.

Varicella Zoster Virus Central Nervous System Immune Reconstitution Inflammatory Syndrome Presenting in a Child

A HIV-positive child presented with acute onset of right hemiplegia, facial palsy and dysphasia 4 weeks after commencing highly active antiretroviral therapy. Magnetic resonance imaging confirmed a left-sided cerebral infarct. Cerebrospinal fluid polymerase chain reaction was positive for varicella zoster virus. This is the first reported pediatric case of varicella zoster virus-related immune reconstitution inflammatory syndrome involving the central nervous system.

Efficacy of in-service nutrition training for mid-level providers to improve feeding practices among HIV-positive children in Tanga, Tanzania: study protocol for a cluster randomized controlled trial.

BackgroundFeeding practices and child undernutrition can be improved when trained health workers provide proper nutrition counseling to caregivers. However, this important management component is difficult to achieve in countries where trained health workers are limited; Tanzania is no exception. In rural and semi-urban areas, mid-level providers (MLPs) are left to manage diseases such as HIV/AIDS.Training health workers in nutrition has been shown to be an effective intervention among HIV-negative children elsewhere, but no studies have been conducted among HIV-positive children. Furthermore, in Tanzania and other countries with MLPs, no evidence currently exists demonstrating an improvement in nutrition among children who receive health services given by MLPs. This study thus aims to examine the efficacy of nutrition training of MLPs on feeding practices and the nutrition status of HIV-positive children in Tanga, Tanzania.Methods/DesignWe will conduct a cluster randomized controlled trial in care and treatment centers (CTCs) in Tanga, Tanzania. The CTCs will be the unit of randomization. We will select 16 CTCs out of 32 for this study, of which we will randomly assign 8 to the intervention arm and 8 to the control arm by coin flipping. From the selected CTCs we will attempt to recruit a total of 800 HIV-positive children aged 6 months to 14 years, half of whom will be receiving care and/or treatment in the CTCs of the intervention arm, and the other half of whom will be receiving care and/or treatment in the CTCs of the control arm (400 children in each condition).We will provide nutrition training to MLPs of the CTCs selected for the intervention arm. In this intervention, we will use the World Health Organization guidelines on nutrition training of health workers for HIV-positive children aged 6 months to 14 years. The trained MLPs will then provide tailored nutrition counseling to caregivers of children being treated at the 8 CTCs of the intervention arm. We will measure nutrition status and child feeding practices monthly for a total of six months.ConclusionsResults of this trial will help expanding undernutrition interventions among HIV-positive children in Tanzania and other countries.Trial registrationCurrent Controlled Trials: ISRCTN65346364.

Human caliciviruses detected in HIV‐seropositive children in Kenya

The human caliciviruses (HuCVs) are important causes of gastroenteritis worldwide. Norovirus (NoV) and sapovirus (SaV) have been detected in HIV-seropositive children but the genetic diversity of HuCVs circulating in these individuals is largely unknown. In this study the prevalence and genotype diversity of HuCVs circulating in Kenyan HIV-positive children, with or without diarrhea, from the year 1999 to 2000 was investigated. The overall prevalence of HuCVs was 19% with NoV predominating at 17% (18/105) and SaV present in 5.7% (6/105) of specimens. Human CVs were detected in both symptomatic (24%) and asymptomatic (16%) children. Co-infections with other enteric viruses were detected in 21.6% of children with diarrhea but only in 4.4% of children without diarrhea. Remarkable genetic diversity was observed with 12 genotypes (7 NoV, 5 SaV) being identified in 20 HuCV-infected children. NoV genogroup II (GII) strains predominated with GII.2 and GII.4 each representing 27% of the NoV-positive strains. The GII.4 strain was most closely related to the nonepidemic GII.4 Kaiso 2003 variant. Other NoV genotypes detected were GI.3, GII.6, GII.12, GII.14, and GII.17. Five different SaV genotypes (GI.2, GI.6, GII.1, GII.2, and GII.4) were characterized from six specimens. Diarrheal symptoms were not associated with any specific HuCV genotype. Overall the HuCV genotype distribution detected in this study reflects those in other studies worldwide. The strains detected are closely related to genotypes that have circulated on several continents since the year 2000.

Optimal time for initiating antiretroviral therapy (ART) in HIV-infected, treatment-naive children aged 2 to 5 years old.

The use of combination antiretroviral therapy (cART) comprising three antiretroviral medications from at least two classes of drugs is the current standard treatment for HIV infection in adults and children. Current World Health Organization (WHO) guidelines for antiretroviral therapy recommend early treatment regardless of immunologic thresholds or the clinical condition for all infants (less than one years of age) and children under the age of two years. For children aged two to five years current WHO guidelines recommend (based on low quality evidence) that clinical and immunological thresholds be used to identify those who need to start cART (advanced clinical stage or CD4 counts ≤ 750 cells/mm(3) or per cent CD4 ≤ 25%). This Cochrane review will inform the current available evidence regarding the optimal time for treatment initiation in children aged two to five years with the goal of informing the revision of WHO 2013 recommendations on when to initiate cART in children. To assess the evidence for the optimal time to initiate cART in treatment-naive, HIV-infected children aged 2 to 5 years. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the AEGIS conference database, specific relevant conferences, www.clinicaltrials.gov, the World Health Organization International Clinical Trials Registry platform and reference lists of articles. The date of the most recent search was 30 September 2012. Randomised controlled trials (RCTs) that compared immediate with deferred initiation of cART, and prospective cohort studies which followed children from enrolment to start of cART and on cART. Two review authors considered studies for inclusion in the review, assessed the risk of bias, and extracted data on the primary outcome of death from all causes and several secondary outcomes, including incidence of CDC category C and B clinical events and per cent CD4 cells (CD4%) at study end. For RCTs we calculated relative risks (RR) or mean differences with 95% confidence intervals (95% CI). For cohort data, we extracted relative risks with 95% CI from adjusted analyses. We combined results from RCTs using a random effects model and examined statistical heterogeneity. Two RCTs in HIV-positive children aged 1 to 12 years were identified. One trial was the pilot study for the larger second trial and both compared initiation of cART regardless of clinical-immunological conditions with deferred initiation until per cent CD4 dropped to <15%. The two trials were conducted in Thailand, and Thailand and Cambodia, respectively. Unpublished analyses of the 122 children enrolled at ages 2 to 5 years were included in this review. There was one death in the immediate cART group and no deaths in the deferred group (RR 2.9; 95% CI 0.12 to 68.9). In the subgroup analysis of children aged 24 to 59 months, there was one CDC C event in each group (RR 0.96; 95% CI 0.06 to 14.87) and 8 and 11 CDC B events in the immediate and deferred groups respectively (RR 0.95; 95% CI 0.24 to 3.73). In this subgroup, the mean difference in CD4 per cent at study end was 5.9% (95% CI 2.7 to 9.1). One cohort study from South Africa, which compared the effect of delaying cART for up to 60 days in 573 HIV-positive children starting tuberculosis treatment (median age 3.5 years), was also included. The adjusted hazard ratios for the effect on mortality of delaying ART for more than 60 days was 1.32 (95% CI 0.55 to 3.16). This systematic review shows that there is insufficient evidence from clinical trials in support of either early or CD4-guided initiation of ART in HIV-infected children aged 2 to 5 years. Programmatic issues such as the retention in care of children in ART programmes in resource-limited settings will need to be considered when formulating WHO 2013 recommendations.

Pulmonary tuberculosis in severely-malnourished or HIV-infected children with pneumonia: a review.

Presentation of pulmonary tuberculosis (PTB) as acute pneumonia in severely-malnourished and HIV-positive children has received very little attention, although this is very important in the management of pneumonia in children living in communities where TB is highly endemic. Our aim was to identify confirmed TB in children with acute pneumonia and HIV infection and/or severe acute malnutrition (SAM) (weight-for-length/height or weight-for-age z score <-3 of the WHO median, or presence of nutritional oedema). We conducted a literature search, using PubMed and Web of Science in April 2013 for the period from January 1974 through April 2013. We included only those studies that reported confirmed TB identified by acid fast bacilli (AFB) through smear microscopy, or by culture-positive specimens from children with acute pneumonia and SAM and/or HIV infection. The specimens were collected either from induced sputum (IS), or gastric lavage (GL), or broncho-alveolar lavage (BAL), or percutaneous lung aspirates (LA). Pneumonia was defined as the radiological evidence of lobar or patchy consolidation and/or clinical evidence of severe/ very severe pneumonia according to the WHO criteria of acute respiratory infection. A total of 17 studies met our search criteria but 6 were relevant for our review. Eleven studies were excluded as those did not assess the HIV status of the children or specify the nutritional status of the children with acute pneumonia and TB. We identified only 747 under-five children from the six relevant studies that determined a tubercular aetiology of acute pneumonia in children with SAM and/or positive HIV status. Three studies were reported from South Africa and one each from the Gambia, Ethiopia, and Thailand where 610, 90, 35, and 12 children were enrolled and 64 (10%), 23 (26%), 5 (14%), and 1 (8%) children were identified with active TB respectively, with a total of 93 (12%) children with active TB. Among 610 HIV-infected children in three studies from South Africa and 137 SAM children from other studies, 64 (10%) and 29 (21%) isolates of M. tuberculosis were identified respectively. Children from South Africa were infected with HIV without specification of their nutritional status whereas children from other countries had SAM but without indication of their HIV status. Our review of the existing data suggests that pulmonary tuberculosis may be more common than it is generally suspected in children with acute pneumonia and SAM, or HIV infection. Because of the scarcity of data, there is an urgent need to investigate PTB as one of the potential aetiologies of acute pneumonia in these children in a carefully-conducted larger study, especially outside Africa.

Nasopharyngeal bacterial colonisation in HIV‐positive children in Cambodia

To determine patterns of nasopharyngeal colonisation in HIV-positive children. Nasopharyngeal, nasal and ear swabs were prospectively taken from all children living in two paediatric nursing homes for HIV-positive orphans in Cambodia from 2004 to 2011. A total of 882 swabs were taken, of which 586 tested positive for bacteria. Staphylococcus aureus was the most frequently isolated species (178 isolates; 30.4%) followed by Streptococcus pneumoniae (103 isolates; 17.6%) and Klebsiella pneumoniae (99 isolates; 16.9%). The rate of S.pneumoniae decreased in 2009 when a vaccination programme was introduced. The respiratory tract of HIV-positive children receiving highly active antiretroviral therapy is commonly colonised by S.aureus and S.pneumoniae, while other species normally found in the respiratory tract, such as Moraxella catarrhalis, are far less frequent.

Prevalence of Dental Caries and its Impact on Quality of Life (QoL) among HIV-infected Children in Kenya

To determine the prevalence of dental caries and its impact on QoL among HIV-infected children in Kenya. Cross-sectional survey of HIV-positive children aged 3-15 years. Two hundred and twenty participants were selected by consecutive sampling. Dental examination was undertaken to determine the presence of dental caries among the children using the dmft/DMFT indices. The children's perceived QoL in the domains of oral symptoms, functional limitations, emotional and social wellbeing was assessed using the WHO Simplified Oral Health Questionnaires for children. The overall prevalence of dental caries was 65% whence the prevalence in the deciduous dentition was 50% while that of the permanent dentition was 30.9%. The mean dmft and DMFTscores were 1.75 and 1.08 respectively. Children with high dmft manifested negative impacts on appearance, chewing, biting hard foods and missing school on account of toothache and discomfort, while in the permanent dentition children with high DMFT had a negative impact on biting hard foods. A high caries experience had significant negative impacts on the children's QoL, especially in the primary dentition.

Immune Status of HIV – Positive Children with Acute Rhinosinusitis

The immune status of 25 HIV-positive children with Acute Rhinosinusitis (ARS) has been studied in comparison with the control group of 14 practically healthy children of the same age. HIV-infected patients with ARS have shown deep infringements of the immune status, especially of T-cells and its subpopulations, and impairments of the humoral immunity, suppression of anti-inflammatory cytokine IL-10 and increase of pro-inflammatory IFN-γ. After conducted treatment we have not seen any certain changes of the immune status in HIV positive patients, even in the cases with clinical improvement. It is possible to ascertain only positive changes of IL-10 maintenance and parallel decrease of IFN-γ in the dynamics of treatment. DOI: http://dx.doi.org/10.11591/ijphs.v2i3.2904 Full Text: PDF

SASOP Biological Psychiatry Congress 2013 Abstracts

SASOP Biological Psychiatry Congress 2013 Abstracts

Children and adolescents with HIV

Larry Chang and colleagues1 have provided a timely Review of strategies for implementation of HIV prevention, including an excellent discussion of advances in prevention of mother-to-child transmission. However, they did not mention the needs of exposed or infected children or those of adolescents, who constitute the highest risk group for new infection. Since the start of the global AIDS response, HIV-positive children and adolescents have consistently been omitted from the research agenda and thus have not been included in the implementation of effective interventions.

Impact of sociodemographic factors on cognitive function in school-aged HIV-infected Nigerian children

BackgroundIn this study, we sought to evaluate the influence of sociodemographic factors, ie, age, sex, socioeconomic status, maternal education, and human immunodeficiency virus (HIV) status, on cognitive performance in school-aged HIV-infected Nigerian children.MethodsSixty-nine HIV-positive children aged 6–15 years were matched with 69 HIV-negative control children for age and sex. The children were subdivided for the purpose of analysis into two cognitive developmental stages using Piaget’s staging, ie, the concrete operational stage (6–11 years) and the formal operational stage (12–15 years). All participants underwent cognitive assessment using Raven’s Standard Progressive Matrices (RPM). Sociodemographic data for the study participants, ie, age, sex, socioeconomic status, and level of maternal education, were obtained using a study proforma. Logistic regression analyses were used to determine associations of HIV status and sociodemographic characteristics with RPM cognitive scores.ResultsThe overall mean RPM score for the HIV-positive children was 18.2 ± 9.8 (range 8.0–47.0) which was significantly lower than the score of 27.2 ± 13.8 (range 8.0–52.0) for the HIV-negative children (P < 0.001). On RPM grading, 56.5% of the HIV-positive children had cognitive performance at below average to intellectually defective range. Below average RPM scores were found to be significantly associated with younger age (6–11 years), positive HIV status, lower socioeconomic status, and low level of maternal education.ConclusionYounger age, poor socioeconomic status, and low level of maternal education were factors apart from HIV infection that were significantly associated with low cognitive function in school-aged HIV-infected Nigerian children.