Neurodevelopmental outcomes in HIV-exposed-uninfected children versus those not exposed to HIV

Area of Science:

• Pediatric Neurodevelopment
• Infectious Diseases
• Global Health

Background:

• Children born to mothers with human immunodeficiency virus (HIV) may experience neurodevelopmental (ND) differences.
• Prenatal and perinatal exposure to HIV and antiretroviral drugs, or environmental factors, may contribute to these differences.

Purpose of the Study:

• To assess and compare neurodevelopmental outcomes in HIV-exposed uninfected (HEU) children and HIV-unexposed uninfected (HUU) children.
• To identify specific areas of neurodevelopment that may be affected by HIV exposure in utero and perinatally.

Main Methods:

• A multicenter study in Thailand and Cambodia involving 160 HEU and 167 HUU children.
• Neurodevelopmental assessments included Beery Visual Motor Integration (VMI), Color Trails, Perdue Pegboard, Child Behavior Checklist (CBCL), Wechsler Intelligence Scale (IQ), and Stanford-Binet II memory tests.
• Statistical analyses adjusted for caregiver education, parental caregiving, household income, age, and ethnicity.

Main Results:

• HEU children demonstrated statistically significant lower scores in verbal IQ (VIQ), full-scale IQ (FSIQ), and Binet Bead Memory compared to HUU children.
• Adjusted mean differences for VIQ, FSIQ, and Binet Bead Memory were -6.13, -4.57, and -3.72, respectively.
• No significant differences were found in performance IQ, other memory domains, Color Trail, Perdue Pegboard, Beery VMI, or CBCL scores.

Conclusions:

• HIV-exposed uninfected (HEU) children exhibit minor reductions in specific neurodevelopmental outcomes compared to HIV-unexposed uninfected (HUU) children.
• The observed neurodevelopmental differences are small, and their immediate and long-term clinical significance requires further investigation.
• These findings highlight the importance of continued monitoring of neurodevelopmental trajectories in HEU populations.