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Neurodevelopmental outcomes of Ugandan infants with HIV infection: an application of growth curve analysis
D Drotar1, K Olness, M Wiznitzer
1Department of Pediatrics, Case Western Reserve University School of Medicine, USA. dxd3@po.cwru.edu
Insights
Human immunodeficiency virus Type 1 (HIV-1) infection in infants born to non-drug-using mothers is linked to poorer neurodevelopmental outcomes. HIV-1 infected infants showed delays in mental and motor development compared to uninfected peers.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurodevelopmental Science
Background:
- Infants born to mothers with human immunodeficiency virus Type 1 (HIV-1) face potential neurodevelopmental challenges.
- Understanding these outcomes is crucial for early intervention and improved care.
- This study focuses on non-drug-using mothers to isolate the impact of HIV-1.
Purpose of the Study:
- To assess the neurodevelopmental outcomes of HIV-1-infected infants from birth to 24 months.
- To compare developmental trajectories between HIV-1-infected infants, seroreverters, and uninfected infants.
- To investigate the influence of neurological status on developmental scores in HIV-1-infected infants.
Main Methods:
- A prospective, controlled study involving 3 groups of infants: HIV-1-infected, uninfected (seroreverters), and uninfected infants of uninfected mothers.
- Neurodevelopmental assessment using the Bayley Scales of Infant Development and the Fagan Test of Infant Intelligence.
- Evaluation of infants from birth to 24 months of age.
Main Results:
- HIV-1-infected infants exhibited significantly lower mental and motor development scores compared to seroreverters and uninfected infants.
- A greater deceleration in the rate of motor development was observed in HIV-1-infected infants.
- HIV-1-infected infants with abnormal neurologic exams had poorer cognitive and motor scores than those with normal exams.
- No significant group differences were found in visual information processing using the Fagan Test.
Conclusions:
- Congenital HIV-1 infection adversely affects neurodevelopment, particularly motor and mental development, in infants.
- Early identification of neurological abnormalities in HIV-1-infected infants is associated with more severe developmental deficits.
- Visual information processing appears to be a more resilient cognitive domain in this population.
Abstract:
Neurodevelopmental outcomes of human immunodeficiency virus Type 1 (HIV-1)-infected infants of non-drug-using mothers were assessed in a controlled, prospective study from birth to 24 months with 3 groups: 61 infants of HIV-infected mothers, 234 uninfected infants of HIV-infected mothers (seroreverters), and 115 uninfected infants of uninfected mothers. Compared with seroreverters and uninfected infants, HIV-infected infants demonstrated lower mental and motor development on the Bayley Scales and greater deceleration in their rate of motor development. HIV-infected infants with abnormal neurologic exams had lower motor and mental test scores and lower rates of motor Bayley Scales scores than their HIV-infected counterparts with normal neurologic exams. Contrary to prediction, no group differences in mean performance or growth rates were found on visual information processing on the Fagan Test of Infant Intelligence.
