ArticleBMC medicine2024
Association of in utero HIV exposure with child brain structure and language development: a South African birth cohort study.
Article in BMC medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Mother-to-child HIV exposure and its relation with neurodevelopmental disorders: a systematic review and meta-analysis.Pediatric research · 2026Pooled it
- The association between maternal immune activation and brain structure and function in human offspring: a systematic review.Molecular psychiatry · 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
- Predictors of Preschool Neurodevelopmental Outcomes and Trajectories in a South African Birth Cohort.Research square · 2026Article
- Placenta models for HIV-1-ART-nicotine comorbidity research: advances and remaining challenges.Cell death discovery · 2026Review
- 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
- 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
- Review
- CEST MRI detects antiretroviral drug toxicities in the developing mouse brain.Frontiers in pharmacology · 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
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundThere is a growing population of children with in utero HIV exposure who are at risk of poor neurodevelopmental outcomes despite avoiding HIV infection. However, the underlying neurobiological pathways are not understood and neuroimaging studies are lacking. We aimed to investigate the cortical brain structure of children who are HIV-exposed and uninfected (HEU) compared to HIV-unexposed (HU) children and to examine the relationship with neurodevelopment.
methodsThe Drakenstein Child Health birth cohort study enrolled pregnant women from a high HIV prevalence area in South Africa with longitudinal follow-up of mother-child pairs. High-resolution magnetic resonance imaging scans from 162 children (70 HEU; 92 HU) were acquired at 2-3 years of age. All HEU children were born to mothers taking antiretroviral therapy. Measures of brain structure (cortical thickness and surface area) in the prefrontal cortex regions were extracted from T1-weighted images and compared between groups using multivariate analysis of variance and linear regression. Child development, assessed using the Bayley Scales of Infant and Toddler Development-III, was correlated with cortical structure, and mediation analyses were performed.
resultsAnalyses demonstrated an association between HIV exposure and cortical thickness across the prefrontal cortex (p = 0.035). Children who were HEU had thicker cortices in prefrontal regions, with significantly greater cortical thickness in the medial orbitofrontal cortex (mOFC) bilaterally compared to HU children (3.21 mm versus 3.14 mm, p = 0.009, adjusted effect size 0.44 [95% CI 0.12 to 0.75]). Estimates held across multiple sensitivity analyses. There were no group differences in cortical surface area. Language scores, which were lower in HEU versus HU children (81.82 versus 86.25, p = 0.011, effect size - 0.44 [95% CI - 0.78 to - 0.09]), negatively correlated with prefrontal cortical thickness in both groups. Cortical thickness in the mOFC mediated the relationship between HIV exposure and poor language outcomes (Sobel test p = 0.032).
conclusionsIn this cohort study, exposure to HIV during pregnancy was associated with altered cortical structure in early life. Our findings indicate that differences in cortical thickness development in the prefrontal region in children who are HEU may be a pathway leading to language impairment. Longitudinal studies are needed to determine the lasting impact.
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