ArticleJournal of the International AIDS Society2019
Low risk of neurodevelopmental impairment among perinatally acquired HIV-infected preschool children who received early antiretroviral treatment in Thailand.
Article in Journal of the International AIDS Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- The cognitive remediation of attention in HIV-associated neurocognitive disorders (HAND): A meta-analysis and systematic review.F1000Research · 2023Pooled it
- Developmental delay and associated factors among HIV-infected under-five children in public health facilities, Southern Ethiopia.Scientific reports · 2024Article
- Adults with Perinatally Acquired HIV; Emerging Clinical Outcomes and Data Gaps.Tropical medicine and infectious disease · 2024Review
- Central Nervous System Impact of Perinatally Acquired HIV in Adolescents and Adults: an Update.Current HIV/AIDS reports · 2022Review
- Neurobehavioral outcomes in young adults with perinatally acquired HIV.AIDS (London, England) · 2020Article
- State of the Mind: Growing up with HIV.Paediatric drugs · 2020Review
- Observational
- Contemporary Issues in Pregnancy (and Offspring) in the Current HIV Era.Current HIV/AIDS reports · 2019Review
- Low risk of neurodevelopmental impairment among perinatally acquired HIV-infected preschool children who received early antiretroviral treatment in Thailand.Journal of the International AIDS Society · 2019Article
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Authors and funding
13 authors at 5 institutions in 3 countries.
Funding
Abstract
introductionAntiretroviral therapy (ART) is recommended in perinatally HIV-infected (PHIV) infants immediately upon diagnosis. We aimed to compare neurodevelopmental outcomes between PHIV children who initiated ART within 12 months of life and perinatally HIV-exposed uninfected (PHEU) children and to assess neurodevelopmental outcomes by timing of ART.
methodsThis prospective cohort study included Thai children aged 12 to 56 months who were assessed with the Mullen Scales of Early Learning (MSEL) at enrolment and at 48 weeks. Global Developmental Impairment (GDI) was defined as Early Learning Composite (ELC) ≤ 70 on the MSEL; typical developmental pattern was defined as ELC > 70 at both visits. Logistic regression was used to compare prevalence of any GDI. Predictors of changing ELC scores were analysed with generalized estimating equations linear regression model.
resultsFrom 2016 to 2017, 50 PHIV (twenty-seven early ART within three months and twenty-three standard ART within three to twelve months) and 100 PHEU children were enrolled. Median (IQR) age at first assessment was 28 (19 to 41) months. PHIV children had lower age-relevant Z scores for weight, height and head circumference compared to the PHEU group (p < 0.05). The prevalence of overall GDI was 18% (95% CI 11 to 27) and 32% (95% CI 20 to 47) in PHEU and PHIV children respectively (p = 0.06). In subgroup analysis, 22% (95% CI 9 to 42) of early ART PHIV children and 44% (95% CI 23 to 66) of standard ART PHIV children had overall GDI. There was a higher rate of GDI in standard ART PHIV children (p = 0.01), but not in the early ART group (p = 0.62) when compared with PHEU children. The standard ART PHIV group demonstrated lower typical developmental pattern than both the early ART PHIV group and the PHEU group (57% vs. 77% vs. 82% respectively). Non-attendance at nursery school was associated with changes in ELC score during study participation (adjusted coefficient -3.8; 95% CI -6.1 to -1.6, p = 0.001).
conclusionsPreschool children with HIV who initiated ART in the first three months of life had a similar rate of GDI as PHEU children. Lack of nursery school attendance predicted poor developmental trajectory outcomes among PHIV children.
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