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Cognitive functioning in school-aged children with vertically acquired HIV infection being treated with highly active

Staci C Martin1, Pamela L Wolters, Mary Anne Toledo-Tamula

  • 1HIV and AIDS Malignancy Branch, National Cancer Institute, 9030 Old Georgetown Road, Bethesda, MD 20814, USA. martins@mail.nih.gov

Developmental Neuropsychology
|September 26, 2006
PubMed

Insights

Children with HIV on HAART therapy may still face cognitive challenges, particularly those with brain scan abnormalities or lower CD4 counts. Neuropsychological assessments are crucial for early detection and intervention in these cases.

Area of Science:

  • Pediatric Neurology
  • Neuroimmunology
  • Infectious Diseases

Background:

  • Highly Active Antiretroviral Therapy (HAART) has reduced severe central nervous system (CNS) manifestations in children with HIV-1.
  • However, the neurocognitive profiles of HIV-infected children on HAART require further investigation.

Purpose of the Study:

  • To systematically examine the relationship between cognitive functioning and medical markers in HIV-infected children and adolescents receiving HAART.
  • To assess the impact of computed tomography (CT) brain scan abnormalities on neurocognitive outcomes.

Main Methods:

  • Administered the Wechsler Intelligence Scale for Children-Third Edition to 41 vertically infected children on HAART for at least one year.
  • Collected data on CT brain scans, CD4 cell counts, and plasma HIV-1 RNA PCR.

Main Results:

  • Global cognitive functioning was in the Average range for all participants.
  • Children with minimal to moderate CT brain scan abnormalities performed significantly worse on cognitive measures, especially executive functions, compared to those with normal scans.
  • Lower CD4+ counts (< or = 500) correlated with lower scores in processing speed, while viral load showed no association with cognitive performance.

Conclusions:

  • Children with HIV on HAART therapy remain at risk for CNS disease.
  • Neuropsychological assessments are vital for this population, particularly for those with cortical atrophy or CD4+ cell counts < or = 500.

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