ArticleJournal of the International AIDS Society2022
Early structural brain development in infants exposed to HIV and antiretroviral therapy in utero in a South African birth cohort.
Article in Journal of the International AIDS Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Assessing the combined impact of pesticide exposure and HIV/ART on child neurodevelopment in Eastern and Southern Africa: a systematic review.BMC pediatrics · 2025Pooled it
- Brain Structure of South African Children Born to Mothers on Dolutegravir Versus Efavirenz-Based Antiretroviral Therapy.Journal of the Pediatric Infectious Diseases Society · 2026Trial
- Growth, physical, and cognitive function in children who are born HIV-free: School-age follow-up of a cluster-randomised trial in rural Zimbabwe.PLoS medicine · 2024Trial
- Bridging the gap: Translating fetal, infant, and toddler neuroimaging insights into clinical practice.Developmental cognitive neuroscience · 2026Review
- Lower working memory and processing speed among children and youth exposed to HIV.AIDS (London, England) · 2026Article
- Persistent neuroimmune alterations in children who are HIV-exposed but uninfected at age 6-7 years: Associations with language development in a South African birth cohort.bioRxiv : the preprint server for biology · 2026Article
- Antenatal maternal anaemia and infant brain structure: high-field (3 T) and ultra-low-field (64 mT) MRI findings from South Africa.Brain communications · 2026Article
- Review
- Brain ultrasound radiomics identify textural differences in basal ganglia and white matter between full term newborns HIV-exposed uninfected and HIV-unexposed in Botswana.Early human development · 2025Observational
- Structural brain differences in school-aged children who are HIV-exposed uninfected.BMC medicine · 2025Article
- Care of the Child Perinatally Exposed to Human Immunodeficiency Virus.Clinics in perinatology · 2024Review
- Feasibility of Brain Ultrasound Performed by Nurses in the Evaluation of Newborns Who Are HIV Exposed in Utero and Uninfected: A Pilot Study in Botswana.Children (Basel, Switzerland) · 2024Article
- Subcortical Brain Volumes and Neurocognitive Function in Children With Perinatal HIV Exposure: A Population-Based Cohort Study in South Africa.Open forum infectious diseases · 2024Article
- Distinct alterations in white matter properties and organization related to maternal treatment initiation in neonates exposed to HIV but uninfected.Scientific reports · 2024Article
- Association of in utero HIV exposure with child brain structure and language development: a South African birth cohort study.BMC medicine · 2024Article
- Distinct alterations in white matter properties and organization related to maternal treatment initiation in neonates exposed to HIV but uninfected.bioRxiv : the preprint server for biology · 2024Article
- Perinatal exposure to atazanavir-based antiretroviral regimens in a mouse model leads to differential long-term motor and cognitive deficits dependent on the NRTI backbone.Frontiers in molecular neuroscience · 2024Article
- Language outcomes of preschool children who are HIV-exposed uninfected: An analysis of a South African cohort.PloS one · 2024Article
- Neurodevelopment among children exposed to HIV and uninfected in sub-Saharan Africa.Journal of the International AIDS Society · 2023Article
- Neurodevelopment of children who are HIV-exposed and uninfected in Kenya.Journal of the International AIDS Society · 2023Article
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Authors and funding
11 authors at 5 institutions in 3 countries.
Funding
Abstract
introductionThere is a growing population of children who are HIV-exposed and uninfected (HEU) with the successful expansion of antiretroviral therapy (ART) use in pregnancy. Children who are HEU are at risk of delayed neurodevelopment; however, there is limited research on early brain growth and maturation. We aimed to investigate the effects of in utero exposure to HIV/ART on brain structure of infants who are HEU compared to HIV-unexposed (HU).
methodsMagnetic resonance imaging using a T2-weighted sequence was undertaken in a subgroup of infants aged 2-6 weeks enrolled in the Drakenstein Child Health Study birth cohort, South Africa, between 2012 and 2015. Mother-child pairs received antenatal and postnatal HIV testing and ART per local guidelines. We compared subcortical and total grey matter volumes between HEU and HU groups using multivariable linear regression adjusting for infant age, sex, intracranial volume and socio-economic variables. We further assessed associations between brain volumes with maternal CD4 cell count and ART exposure.
resultsOne hundred forty-six infants (40 HEU; 106 HU) with high-resolution images were included in this analysis (mean age 3 weeks; 50.7% male). All infants who were HEU were exposed to ART (88% maternal triple ART). Infants who were HEU had smaller caudate volumes bilaterally (5.4% reduction, p < 0.05) compared to HU infants. There were no group differences in other subcortical volumes (all p > 0.2). Total grey matter volume was also reduced in infants who were HEU (2.1% reduction, p < 0.05). Exploratory analyses showed that low maternal CD4 cell count (<350 cells/mm
conclusionsLower caudate and total grey matter volumes were found in infants who were HEU compared to HU in the first weeks of life, and maternal immunosuppression was associated with reduced volumes. These findings suggest that antenatal HIV exposure may impact early structural brain development and improved antenatal HIV management may have the potential to optimize neurodevelopmental outcomes of children who are HEU.
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