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Published on: January 7, 2019
A behavioral and cognitive profile of clinically stable HIV-infected children
Molly L Nozyce1, Sophia S Lee, Andrew Wiznia
1Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, New York, USA. molly.nozyce@nbhn.net
Insights
Stable HIV-infected children show more behavioral issues and lower cognitive scores than typical children. These findings highlight the need for comprehensive support for pediatric HIV management.
Area of Science:
- Pediatric Neuropsychology
- Infectious Diseases
- Child Psychology
Background:
- Antiretroviral therapy has improved outcomes for children with HIV.
- Long-term effects of HIV and its treatment on neurodevelopment require further investigation.
- Understanding behavioral and cognitive profiles is crucial for managing chronic childhood illnesses.
Purpose of the Study:
- To characterize the behavioral and cognitive functioning of clinically and immunologically stable, antiretroviral-experienced, HIV-infected children.
- To identify specific behavioral problems and cognitive deficits in this population.
- To explore correlations between neuropsychological measures, age, and CD4+ T-cell counts.
Main Methods:
- A cohort of 274 previously treated HIV-infected children (aged 2-17 years) underwent comprehensive behavioral, developmental, and cognitive assessments.
- Standardized instruments, including the Conners' Parent Rating Scale and Wechsler Intelligence Scale for Children-III, were utilized.
- Statistical analyses examined relationships between neuropsychological outcomes, age, and CD4+ T-cell counts.
Main Results:
- The most prevalent behavioral issues included psychosomatic problems (28%), learning difficulties (25%), and hyperactivity (20%).
- Mean scores on the Wechsler Intelligence Scale for Children-III (Verbal IQ: 85, Performance IQ: 90, Full-Scale IQ: 86) were below population norms.
- Hyperactivity correlated with lower performance IQ (<90), anxiety with older age (≥9 years), and conduct disorder with lower CD4+ counts (<660 cells/mm³).
Conclusions:
- Clinically and immunologically stable HIV-infected children exhibit a higher prevalence of behavioral problems compared to general population norms.
- These children also demonstrate lower developmental and cognitive scores, indicating persistent neurodevelopmental challenges.
- The findings underscore the importance of ongoing neurodevelopmental monitoring and targeted interventions for HIV-infected children.
Objective:
The purpose of this research was to characterize behavioral and cognitive profiles of clinically and immunologically stable antiretroviral-experienced HIV-infected children.
Methods:
Two hundred seventy-four previously treated HIV-infected children aged 2 to 17 years were assessed for behavioral, developmental, and cognitive functioning. Correlations between neuropsychological measures, age, and CD4 lymphocyte count were investigated.
Results:
The most common behavioral problems, as measured by the Conners' Parent Rating Scale, were psychosomatic (28%), learning (25%), hyperactivity (20%), impulsive-hyperactive (19%), conduct (16%), and anxiety (8%) problems. Mean Wechsler Intelligence Scale for Children-III scores were less than established population norms; the mean verbal IQ was 85, the mean performance IQ was 90, and the mean full-scale score was 86. Hyperactivity was more frequent in children with a Wechsler Intelligence Scale for Children-III performance IQ of <90. Anxiety problems were more likely in children > or =9 years of age. Children with CD4 counts of <660 cells per mm3 were more likely to be identified as having a conduct disorder. No association was noted between behavioral problems and neuroimaging.
Conclusions:
Clinically and immunologically stable HIV-infected children had more frequent behavioral problems and lower developmental and cognitive scores than established childhood norms.
