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Published on: October 6, 2022
Developmental status of preschool children receiving cART: a descriptive cohort study
J Potterton1, N Hilburn1, R Strehlau2
1Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Children with HIV, even on early combination antiretroviral treatment (cART), show significant developmental delays, particularly in speech and cognition. Routine developmental screening is crucial for these preschool-aged children.
Area of Science:
- Paediatric infectious diseases
- Neurodevelopmental disorders
- Global child health
Background:
- Human Immunodeficiency Virus (HIV) is linked to neurodevelopmental issues in young children.
- The developmental impact of HIV on preschool-aged children requires further investigation.
Purpose of the Study:
- To assess the neurodevelopmental status of preschool-aged children living with HIV.
- To identify specific areas of developmental delay in this population.
Main Methods:
- Sixty-eight medically stable children (3-5 years) with HIV in Johannesburg, South Africa, were evaluated.
- The Griffiths Scales of Mental Development was used, excluding children with severe HIV encephalopathy.
Main Results:
- Over 55% of children exhibited severe overall developmental delay.
- Speech, cognition, and perception were the most affected domains.
- Personal-social development was least impacted, with only 13.4% showing severe delay.
Conclusions:
- Early combination antiretroviral treatment (cART) does not fully prevent severe developmental delay in children with HIV.
- Routine developmental screening is recommended for all preschool-aged children with HIV.
- Very early initiation of cART may mitigate developmental risks.
Background:
HIV is known to cause neurodevelopmental problems in infants and young children. The impact of HIV on the development of preschool-age children has been less well described.
Method:
The study was conducted at an urban paediatric HIV clinic in Johannesburg, South Africa. A sample of convenience was used. Sixty-eight medically stable children between the ages of 3 and 5 years were assessed with the Griffiths Scales of Mental Development. Children were excluded from the study if they had severe HIV encephalopathy, which made it impossible for them to participate in the items on the Griffiths Scales of Mental Development.
Results:
The children had started combination antiretroviral treatment (cART) at a mean age of 8.1 months. The majority of the children were virologically suppressed and did not present with wasting or stunting. Severe overall developmental delay (z-scores < -2SD) was detected in 55.88% of children. Developmental facets related to speech, cognition and perception were the most severely affected. Personal-social development was the least affected with only 13.4% of the children demonstrating severe delay.
Conclusion:
Despite having early access to cART, children infected with HIV are still at risk for severe developmental delay across a number of facets. Very early initiation of cART may help alleviate this problem. All preschool children infected with HIV should have routine developmental screening.
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