Neruodevelopmental outcomes in pre-school children living with HIV-1 subtypes A and D in Uganda
Document Type
Article
Department
Paediatrics and Child Health (East Africa)
Abstract
Background: HIV is a neuropathogenic virus that may result in detrimental neurodevelopmental (ND) outcomes early in life. This is the first study to evaluate the effect of HIV-1 subtype on neurodevelopment of Ugandan preschool children.
Methods: Neurodevelopment of 87 HIV-1 infected and 221 HIV exposed uninfected Ugandan children 1.8–4.9 years of age was assessed using 4 scales of the Mullen Scales of Early Learning (MSEL), 2 scales of the Color Object Association Test (COAT), and 1 score of the Early Childhood Vigilance Test. HIV-1 subtype was defined by phylogenetic analyses. General linear models were used to relate test scores to HIV-1 subtype (A versus D) while adjusting for relevant covariates. The scores were benchmarked against HIV exposed uninfected group to facilitate the interpretation.
Results: Seventy-one percentage of children infected with subtype A versus 60% of children with subtype D were currently on antiretroviral therapy (P = 0.49). Children with HIV-1 subtype A infection were older when compared with subtype D (3.29 vs. 2.76 years, respectively, P = 0.03), but similar regarding sex, socioeconomic status, weight-for-age z-score, CD4+ and CD8+ (% and total), viral load. No statistically significant differences by HIV-1 subtype were observed in the MSEL, COAT and Early Childhood Vigilance Test. Differences ≥ 0.33 of the SD were observed for the MSEL Composite Score, Receptive Language (MSEL) and Total Memory (COAT).
Conclusions: In contrast to previously reported differences in ND outcomes of school-age children by HIV-1 subtype, ND scores among preschool children were similar for subtypes A and D, with few potential differences on language production and memory outcomes that favored subtype A. Further investigation with larger sample sizes and longitudinal follow-up is needed
Publication (Name of Journal)
The pediatric infectious diseases journal
DOI
https://doi.org/10.1097%2FINF.0000000000002097
Recommended Citation
Ruiseñor-Escudero, H.,
Sikorskii, A.,
Familiar-Lopez, I.,
Persaud, D.,
Ziemniak, C.,
Nakasujja, N.,
Opoka, R.,
Boivin, M.
(2018). Neruodevelopmental outcomes in pre-school children living with HIV-1 subtypes A and D in Uganda. The pediatric infectious diseases journal.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_paediatr_child_health/474
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Comments
This work was published before the author joined Aga Khan University.