ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
African Multi-Site 2-Year Neuropsychological Study of School-Age Children Perinatally Infected, Exposed, and Unexposed to Human Immunodeficiency Virus.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is Neurodevelopmental Assessment in Early Childhood Predictive of Performance Assessed Later in Childhood and Adolescence in Sub-Saharan Africa? A Systematic Review of the Literature.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2024Pooled it
- Coordination of inflammatory responses in children with perinatally acquired HIV infection.AIDS (London, England) · 2022Trial
- Unique Oral Microbiota Signatures and Neurocognitive Function in Adolescents with and without Perinatally Acquired HIV.Research square · 2026Article
- Executive Function and Adherence in Children and Adolescents Living With HIV: Evidence From the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) Study.Journal of child neurology · 2026Article
- Review
- The effect of environment and in-utero HIV exposure on neurodevelopment in infants.AIDS (London, England) · 2025Article
- Associations between the Strengths and Difficulties Questionnaire (SDQ) and Tests of Variables of Attention (TOVA) in rural school-aged children in Benin Africa.Global mental health (Cambridge, England) · 2025Article
- Cognitive impairment in children and adolescents living with perinatal HIV disease in the ART era: a meta-analysis.EClinicalMedicine · 2024Article
- Psychometric evaluation of the computerized battery for neuropsychological evaluation of children (BENCI) among school aged children in the context of HIV in an urban Kenyan setting.BMC psychiatry · 2023Article
- Validation of the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) in Children and Adolescents with and without HIV Infection in Lusaka, Zambia.AIDS and behavior · 2022Article
- How the Term 'Self-Management' is Used in HIV Research in Low- and Middle-Income Countries: A Scoping Review.AIDS and behavior · 2022Article
- Altered White Matter Tracts in the Somatosensory, Salience, Motor, and Default Mode Networks in 7-Year-Old Children Living with Human Immunodeficiency Virus: A Tractographic Analysis.Brain connectivity · 2022Article
- Neurocognitive deficits and socioeconomic risk factors among children and adolescents living with HIV in sub-Saharan Africa: a systematic review.Child and adolescent psychiatry and mental health · 2022Review
- Nonverbal cognitive assessment of children in Tanzania with and without HIV.Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence · 2022Article
- Antiretroviral choice and severe disease predict poorer neuropsychological outcomes in HIV+ children from Africa.Frontiers in pediatrics · 2022Article
- Mental health and adaptive functioning among school-aged children living with HIV in Zambia.Frontiers in psychiatry · 2022Article
- Childhood lung function following perinatal HIV infection and early antiretroviral therapy initiation: a cross-sectional study.ERJ open research · 2022Article
- Reduced neuronal population in the dorsolateral prefrontal cortex in infant macaques infected with simian immunodeficiency virus (SIV).Journal of neurovirology · 2021Article
- Neurodevelopmental assessment at one year of age predicts neuropsychological performance at six years in a cohort of West African Children.Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence · 2021Article
- Neurodevelopment in early treated HIV-infected infants participating in a developmental stimulation programme compared with controls.Child: care, health and development · 2021Article
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Authors and funding
20 authors.
Funding
Abstract
backgroundChildren living with human immunodeficiency virus (HIV) are at neuropsychological risk for cognitive and motor dysfunction. However, few prospective, multi-site studies have evaluated neuropsychological outcomes longitudinally among perinatally infected African children who received early antiretroviral treatment (ART).
methodsWe enrolled 611 children aged 5 to 11 years at 6 sites (South Africa [3], Zimbabwe, Malawi, Uganda). Of these, there were 246 children living with HIV (HIV+) who were initiated on ART before 3 years of age in a prior clinical trial comparing nevirapine to lopinavir/ritonavir (International Maternal Pediatric Adolescent Acquired Immunodeficiency Syndrome Clinical Trials [IMPAACT] P1060); 183 age-matched, exposed but uninfected (HEU) children; and 182 unexposed and uninfected (HUU) children. They were compared across 3 assessment time points (Weeks 0, 48, and 96) on cognitive ability (Kaufman Assessment Battery for Children, second edition [KABC-II]), attention/impulsivity (Tests of Variables of Attention [TOVA]), motor proficiency (Bruininks-Oseretsky Test, second edition [BOT-2]), and on the Behavior Rating Inventory of Executive Function (BRIEF). The cohorts were compared using linear mixed models, adjusting for site, child's age and sex, and selected personal/family control variables.
resultsThe HIV+ cohort performed significantly worse than the HEU and HUU cohorts for all KABC-II, TOVA, and BOT-2 performance outcomes across all 3 time points (P values < .001). The HUU and HEU cohorts were comparable. For the KABC-II planning/reasoning subtests, the HIV+ children showed less improvement over time than the HUU and HEU groups. The groups did not differ significantly on the BRIEF.
conclusionsDespite initiation of ART in early childhood and good viral suppression at the time of enrollment, the HIV+ group had poorer neuropsychological performance over time, with the gap progressively worsening in planning/reasoning. This can be debilitating for self-management in adolescence.
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