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Published on: October 6, 2016
Young adults perinatally infected with HIV perform more poorly on measures of executive functioning and motor speed
Elizabeth J Willen1,2,3, Anai Cuadra1, Kristopher L Arheart4
1a Department of Pediatrics, Mailman Center for Child Development , University of Miami, Miller School of Medicine , Miami , FL , USA.
Insights
Young adults with perinatal HIV infection show lasting neurocognitive deficits, particularly in attention and executive functions, compared to healthy peers. Early treatment and higher CD4 counts may positively influence cognitive outcomes.
Area of Science:
- Neuroscience
- Infectious Diseases
- Psychology
Background:
- Perinatal HIV infection can lead to long-term neurocognitive impairments.
- Few studies have investigated the cognitive effects of early HIV infection in adulthood.
Purpose of the Study:
- To evaluate neurocognitive outcomes in young adults with perinatal HIV infection.
- To compare cognitive function between perinatally HIV-infected young adults and healthy controls.
Main Methods:
- Cross-sectional study of 29 HIV+ young adults (18-24 years) and 13 healthy controls.
- Neuropsychological assessment battery and MRI scans were administered.
- Multivariate analysis of covariance and linear regression were used for statistical analysis.
Main Results:
- HIV+ group demonstrated lower scores in attention/working memory and set-shifting compared to controls.
- Nadir CD4 count correlated with better Letter-Number Sequencing scores in the HIV+ group.
- Highly active antiretroviral therapy (HAART) use was associated with improved Category Fluency performance.
Conclusions:
- Executive dysfunction persists in young adults with perinatal HIV infection.
- Neurocognitive deficits impact daily living and functional outcomes.
- Further research is needed to understand the long-term effects of executive dysfunction.
Abstract:
Perinatal HIV is associated with significant neurocognitive morbidities, but few studies have examined cognitive impact of early HIV infection on patients surviving to adulthood. The purpose of this study was to evaluate neurocognitive outcomes among a cohort of perinatally infected young adults. Individuals between the ages of 18 and 24 with perinatal infection were recruited for this cross-sectional study along with similarly aged healthy controls. Participants completed an MRI and brief neuropsychological assessment battery. Multivariate analysis of covariance controlling for age, gender, race/ethnicity, and education was completed to detect differences between the HIV+ and control groups. Multivariable linear regression was performed to assess HIV-associated factors potentially impacting neuropsychological findings among the HIV+ group. Twenty-nine HIV+ young adults and 13 healthy controls were included in the study. After adjusting for age and sociodemographic variables, the HIV+ group scored lower on attention/working memory (Digit Span (p = .008) and Letter-Number Sequencing (p = .038)), set-shifting (DKEFS Trail Making Test Condition 4 (p = .026) and motor speed (DKEFS Trail Making Test Condition 5 (p = .003)). For the HIV+ group, nadir CD4 was associated with better Letter-Number Sequencing score (p = .029) and use of highly active antiretroviral therapy was associated with better performance on Category Fluency (p = .040). After controlling for sociodemographic variables, executive dysfunction persists among young adults with perinatal HIV infection in comparison to controls. Future studies to further elucidate the impact of executive dysfunction on independent living and functional outcomes are indicated.
