Cognitive Function among HIV Infected Children in Pune

Area of Science:

• Pediatric infectious diseases
• Neuropsychology
• Global health

Background:

• Perinatally acquired human immunodeficiency virus (HIV) infection can impact neurodevelopment in children.
• Antiretroviral therapy (ART) is crucial for managing HIV but its long-term effects on cognition require ongoing study.
• Assessing cognitive function in ART-naïve children is essential to understand the direct impact of HIV on the developing brain.

Purpose of the Study:

• To evaluate the cognitive abilities of school-aged children in Pune, India, who were infected with HIV perinatally and had not yet started ART.
• To compare cognitive performance and adaptive behavior between HIV-infected and HIV-uninfected children.

Main Methods:

• A cohort of 50 HIV-infected, ART-naïve children (6-12 years) and 50 age/gender-matched HIV-uninfected controls were recruited.
• Cognitive function was assessed using the Indian Child Intelligence Test (ICIT), covering various domains like memory, learning, and spatial visualization.
• Adaptive behavior was evaluated using the Vineland Social Maturity Scale (VSMS) through caregiver reports and child interviews.

Main Results:

• No significant differences were found in overall ICIT cognitive scores between HIV-infected and uninfected children (p=0.209).
• HIV-infected children demonstrated significantly lower scores on adaptive behavior measures (VSMS) compared to controls (p=0.028).
• Mean CD4 count in HIV-infected children was 588 cells/mm³.

Conclusions:

• While overall cognitive abilities assessed by ICIT were comparable between groups, HIV infection was associated with impaired adaptive behavior in children.
• These findings suggest that HIV may affect daily living skills more than core cognitive functions in this population.
• Larger prospective studies with comprehensive cognitive batteries are recommended to further elucidate HIV's impact on cognitive domains in Indian children.