ArticleJournal of the International AIDS Society2023
Neurodevelopment of children who are HIV-exposed and uninfected in Kenya.
Article in Journal of the International AIDS Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 13 citations in OpenAlex.
- Brain Structure of South African Children Born to Mothers on Dolutegravir Versus Efavirenz-Based Antiretroviral Therapy.Journal of the Pediatric Infectious Diseases Society · 2026Trial
- Lower working memory and processing speed among children and youth exposed to HIV.AIDS (London, England) · 2026Article
- Review
- The effect of environment and in-utero HIV exposure on neurodevelopment in infants.AIDS (London, England) · 2025Article
- Review
- Primary Orbital Teratoma With Congenital Anophthalmia in a Neonate: A Rare Case With Histopathological and Radiological Correlation.Case reports in ophthalmological medicine · 2025Article
- Intelligence and language outcomes in school-aged children who are HIV-exposed, uninfected: the role of sex, perinatal risk factors, and socioeconomic status.Frontiers in pediatrics · 2025Article
- Article
- Exposure to the antiretroviral drug dolutegravir impairs structure and neurogenesis in a forebrain organoid model of human embryonic cortical development.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
- Achieving equity for children and adolescents with perinatal HIV exposure: an urgent need for a paradigm shift.Journal of the International AIDS Society · 2023Article
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Authors and funding
16 authors at 3 institutions in 2 countries.
Funding
Abstract
introductionPredictors of neurodevelopment among children who are HIV-exposed uninfected (CHEU) are poorly understood.
methodsMothers with and without HIV and their children were enrolled during 6-week postnatal care visits across seven sites in Kenya between March 2021 and June 2022. Infant neurodevelopment was assessed using the Malawi Developmental Assessment Tool, including social, language, fine motor and gross motor domains. We used multivariate linear mixed effects models to identify associations between 1-year neurodevelopment scores, HIV and antiretroviral therapy (ART) exposures, and household factors, adjusted for potential confounders and clustered by the site.
resultsAt 1-year evaluation, CHEU (n = 709) and children who are HIV-unexposed uninfected (CHUU) (n = 715) had comparable median age (52 weeks) and sex distribution (49% vs. 52% female). Mothers living with HIV were older (31 vs. 27 years), had lower education (50% vs. 26% primary) and were more likely to be report moderate-to-severe food insecurity (26% vs. 9%) (p < 0.01 for all). Compared to CHUU, CHEU had higher language scores (adjusted coeff: 0.23, 95% CI: 0.06, 0.39) and comparable social, fine and gross motor scores. Among all children, preterm birth was associated with lower gross motor scores (adjusted coeff: -1.38, 95% CI: -2.05, -0.71), food insecurity was associated with lower social scores (adjusted coeff: -0.37, 95% CI: -0.73, -0.01) and maternal report of intimate partner violence (IPV) was associated with lower fine motor (adjusted coeff: -0.76, 95% CI: -1.40, -0.13) and gross motor scores (adjusted coeff: -1.07, 95% CI: -1.81, -0.33). Among CHEU, in utero efavirenz (EFV) exposure during pregnancy was associated with lower gross motor scores compared to dolutegravir (DTG) exposure (adjusted coeff: -0.51, 95% CI: -1.01, -0.03). Lower fine and gross motor scores were also associated with having a single or widowed mother (adjusted coeff: -0.45, 95% CI: -0.87, -0.03) or a deceased or absent father (adjusted coeff: -0.81, 95% CI: -1.58, -0.05), respectively.
conclusionsBiologic and social factors were associated with child neurodevelopment. Despite socio-demographic differences between CHEU and CHUU, 1-year neurodevelopment was similar. Addressing IPV and food insecurity may provide benefits regardless of maternal HIV status. DTG use was associated with higher neurodevelopmental scores in CHEU, compared to EFV regimens, potentially contributing to a lack of neurodevelopmental difference between CHEU and CHUU.
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