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Cognitive assessment of human immunodeficiency virus-exposed children
R L Levenson1, C A Mellins, R Zawadzki
1HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York.
Insights
Cognitive deficits are common in children with human immunodeficiency virus (HIV) infection, with neurologic impairment significantly worsening these issues. Prenatal drug exposure did not impact cognitive functioning.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Infectious Diseases
Background:
- Human immunodeficiency virus (HIV) can impact neurodevelopment in children.
- Understanding cognitive and motor functioning is crucial for managing HIV-infected children.
Purpose of the Study:
- Assess cognitive and motor function in HIV-exposed and HIV-infected children.
- Identify cognitive strengths/weaknesses in HIV-infected children.
- Examine the influence of serostatus, neurologic impairment, and prenatal drug exposure on cognitive function.
Main Methods:
- Cross-sectional, single-blind study design.
- Participants included 41 HIV-infected and 8 seroreverter school-age children.
- Evaluations included the McCarthy Scales of Children's Abilities and the Neurologic Examination for Children.
Main Results:
- General Cognitive Index was in the Borderline range; 44% scored in the Mentally Retarded range.
- Severe deficits observed in Quantitative, Verbal, and Memory scales.
- HIV-infected children with neurologic impairment performed significantly worse than controls.
Conclusions:
- Cognitive deficits are present in both HIV-infected and seroreverted children.
- Neurologic dysfunction significantly exacerbates cognitive deficits in HIV-infected children.
- Gender, ethnicity, and prenatal drug exposure did not significantly affect cognitive outcomes.
Objective:
To determine (1) the level of impairment in cognitive and motor functioning in human immunodeficiency virus (HIV)-exposed and HIV-infected preschool and school-age children; (2) cognitive strengths and weaknesses that characterize HIV-infected children; and (3) potential contributions of serostatus, neurologic impairment, and prenatal drug-exposure to cognitive functioning.
Design:
Cross-sectional, single-blind study.
Setting:
Pediatric neurology clinic at a large metropolitan hospital in New York, NY.
Participants:
Forty-one HIV-infected and eight seroreverter school-age children.
Interventions:
The McCarthy Scales of Children's Abilities were administered to all children, as was the Neurologic Examination for Children.
Measurements/Main Results:
The obtained mean of the sample on the McCarthy Scales' General Cognitive Index was in the Borderline range, with 44% of the subjects scoring in the Mentally Retarded range. The most severe cognitive deficits were found on the Quantitative, Verbal, and Memory scales (Borderline range). Children infected with HIV with neurologic impairment performed significantly worse than did seroverters and neurologically normal HIV-infected children. There were no significant differences in cognitive functioning due to gender, ethnicity, and prenatal drug exposure.
Conclusions:
Cognitive deficits were detected in HIV-infected and seroreverted children. The presence of neurologic dysfunction in HIV-infected children markedly intensified these deficits.