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Children with HIV score below HIV-negative peers in cognitive, motor function tests
Disparity worsens over time despite early HIV treatment, NIH study finds.
What
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases. The observational study included neuropsychological evaluations of 611 children in sub-Saharan Africa. It was conducted by the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT), supported by the National Institute of Allergy and Infectious Diseases (NIAID), the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Mental Health, all components of the National Institutes of Health.
Researchers at the Michigan State University College of Osteopathic Medicine and other collaborating institutions recruited 246 5- to 11-year-olds with HIV who had begun antiretroviral therapy (ART) before age 3 during a previous IMPAACT study. The study participants were given a suite of neuropsychological tests at enrollment, at 48 weeks and at 96 weeks. Two comparator groups of HIV-negative peers who had been exposed to HIV in utero or during birth or breastfeeding, and peers never exposed to HIV, also received the same testing. All children with HIV were on ART during the study and about three-quarters were virally suppressed.
After controlling for age, sex and certain socioeconomic and family factors, the researchers found that participants with HIV had poorer performance on cognitive ability, motor function and attention tests compared to participants without HIV in the two comparator groups, at all three time points. Notably, participants with HIV had significantly less improvement in planning and reasoning abilities than their HIV-negative peers over time. On each test, researchers observed no significant differences between HIV-negative children exposed to HIV and those never exposed to HIV.
The landmark Children with HIV Early Antiretroviral Therapy (CHER) study found in 2008 that immediately initiating ART improved overall health outcomes among infants and children with HIV. However, these new findings suggest that some children may experience neuropsychological difficulties over time, even when HIV is well controlled. Together, these data highlight the need to investigate the underlying mechanism of these neuropsychological challenges, and to develop additional interventions to support children who acquire HIV early in life.
Article
M Boivin et al. African multi-site two-year neuropsychological study of perinatally HIV-infected, exposed and unexposed school-aged children. Clinical Infectious Diseases DOI: 10.1093/cid/ciz1088 (2019).
Who
Anthony S. Fauci, M.D., NIAID Director, is available for comment.
Contact
To schedule interviews, please contact Judith Lavelle, (301) 402-1663, niaidnews@niaid.nih.gov.
NIAID conducts and supports research — at NIH, throughout the United States, and worldwide — to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.
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