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HIV-associated neurodevelopmental delay: prevalence, predictors and persistence in relation to antiretroviral therapy

R Strehlau1, L Kuhn2,3, E J Abrams3,4

  • 1Empilweni Services and Research Unit (ESRU), Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. renate.strehlau@wits.ac.za.

Child: Care, Health and Development
|August 23, 2016
PubMed

Insights

Antiretroviral therapy (ART) improved neurodevelopment in young children with HIV, but delays persist. Further interventions are crucial for maximizing developmental outcomes in these children.

Area of Science:

  • Pediatric Neuroscience
  • Infectious Diseases
  • Developmental Psychology

Background:

  • Infant HIV infection can negatively impact brain development.
  • Early neurodevelopmental consequences are a concern for children with HIV.

Purpose of the Study:

  • To assess neurodevelopmental characteristics in HIV-infected children before and after antiretroviral therapy (ART).
  • To evaluate the impact of viral suppression on neurodevelopmental outcomes in young children with HIV.

Main Methods:

  • The Neverest 2 trial enrolled 195 HIV-infected children under 2 years old.
  • The Ages and Stages Questionnaire (ASQ) was used to screen neurodevelopmental functioning in five domains.
  • Assessments were conducted before ART initiation and after achieving viral suppression.

Main Results:

  • ART initiation and viral suppression led to significant improvements in gross motor, fine motor, problem-solving, and personal-social domains.
  • The communication domain showed no significant change following ART and viral suppression.
  • Despite improvements, a notable proportion of children continued to exhibit neurodevelopmental delays.

Conclusions:

  • Achieving viral suppression with ART significantly enhances neurodevelopmental markers in young HIV-infected children.
  • Persistent neurodevelopmental delays highlight the need for additional interventions.
  • Maximizing developmental outcomes requires continued focus and targeted support for children with HIV.
Abstract

Keywords:
AIDSchild developmentscreening

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