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Impact of HIV severity on cognitive and adaptive functioning during childhood and adolescence

Renee Smith1, Miriam Chernoff, Paige L Williams

  • 1Department of Pediatrics, University of Illinois at Chicago, Chicago, IL 60612, USA. resmith@uic.edu

The Pediatric Infectious Disease Journal
|May 18, 2012
PubMed

Insights

Youth with HIV infection and a prior AIDS-defining illness (Centers for Disease Control and Prevention Class C event) face higher cognitive risks, not adaptive impairments. Early prevention is key for neurodevelopmental health in perinatally HIV-infected youth.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Infectious Diseases

Background:

  • Understanding cognitive and adaptive functioning in perinatally HIV-infected youth (PHIV) is crucial.
  • Disease severity, particularly a history of AIDS-defining illness (Centers for Disease Control and Prevention Class C event), may impact neurodevelopment.
  • Comparison with perinatally HIV-exposed but uninfected (PHEU) youth is essential for context.

Purpose of the Study:

  • To investigate the influence of disease severity on cognitive and adaptive functioning in PHIV youth.
  • To compare cognitive and adaptive outcomes between PHIV youth with (PHIV+/C) and without (PHIV+/NoC) a prior Class C event, and PHEU youth.
  • To identify factors associated with cognitive and adaptive functioning in these groups.

Main Methods:

  • Cross-sectional analysis of 7-16 year old youth from a multisite prospective cohort study.
  • Assessment of cognitive functioning using the Wechsler Intelligence Scale for Children, Fourth Edition.
  • Evaluation of adaptive functioning via the Adaptive Behavior Assessment System, Second Edition, completed by caregivers.

Main Results:

  • Overall mean cognitive and adaptive functioning scores were in the low average range for all groups.
  • PHIV+/C youth had significantly lower mean full-scale IQ scores compared to PHIV+/NoC and PHEU youth after covariate adjustment.
  • Cognitive deficits in PHIV+/C youth were primarily linked to a prior diagnosis of encephalopathy; no significant differences in adaptive functioning were found between groups.

Conclusions:

  • Perinatally HIV-infected youth with a history of Centers for Disease Control and Prevention Class C events are at increased risk for cognitive impairment, irrespective of current health status.
  • This cognitive risk appears attributable to prior encephalopathy, not adaptive functioning deficits.
  • Early preventive therapies are critical for mitigating later neurodevelopmental impairments in this population.
Abstract

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