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Evaluation of motor and cognitive development among infants exposed to HIV
Kaitiana Martins da Silva1, Cristina Dos Santos Cardoso de Sá2, Raquel Carvalho2
1Federal University of São Paulo, Brazil.
Insights
Infants exposed to HIV and antiretroviral therapy (ART) show adequate early motor and cognitive development. However, lower cognitive scores at 8 and 18 months suggest potential future issues, necessitating ongoing monitoring.
Area of Science:
- Pediatrics
- Neurodevelopmental Disorders
- Infectious Diseases
Background:
- Antiretroviral therapy (ART) is crucial for managing HIV infection in infants.
- Understanding the long-term neurodevelopmental effects of in-utero and early-life HIV exposure and ART is essential.
Purpose of the Study:
- To compare motor and cognitive development in HIV-exposed and unexposed infants up to 18 months of age.
- To identify potential developmental delays or differences associated with HIV exposure and ART.
Main Methods:
- A prospective, cross-sectional study involving 80 infants (40 HIV-exposed on ART, 40 unexposed controls).
- Infants were assessed at 4, 8, 12, and 18 months using the Bayley Scale of Infant and Toddler Development.
- Evaluations included motor and cognitive domains, with analysis of scaled scores, composite scores, and percentile ranks.
Main Results:
- A significant group effect was observed, with HIV-exposed infants generally scoring lower in both motor and cognitive domains compared to controls.
- Specifically, HIV-exposed infants showed lower cognitive scores at 8 and 18 months.
- Most infants, including those exposed to HIV, performed at or above average, with one exception of borderline motor development in an 18-month-old exposed infant.
Conclusions:
- Infants exposed to HIV and ART demonstrate adequate motor and cognitive development in the first 18 months.
- Lower cognitive scores at specific ages (8 and 18 months) may signal future developmental challenges.
- Systematic follow-up is recommended for HIV-exposed infants to monitor neurodevelopmental trajectories.
Abstract:
This study of a prospective and cross-sectional nature compared the motor and cognitive development of HIV-exposed and unexposed infants in their first 18months of age. 40 infants exposed to HIV and antiretroviral therapy (Experimental Group - EG) and 40 unexposed infants (Control Group - CG) participated in the study. They were divided into four age groups of 4, 8, 12 and 18months old, with 10 infants from EG and 10 from CG in each group. The infants were evaluated once on motor and cognitive development by the Bayley Scale of Infant and Toddler Development. Performance category grading and comparisons among scaled score, composite score and percentile rank were held. There was significant group effect for scores in motor and cognitive domains showing lower scores for EG regardless of age. In comparison to the CG, the EG presented lower scores for cognitive domain at 8 and 18months. In the performance categories, all infants were classified at or above the average for motor and cognitive development, except of one EG-18month old infant classified as borderline for motor development. Infants exposed to HIV and antiretroviral therapy own adequate cognitive and motor development in the first 18months. However, the lower scores found, particularly on the 8th and 18th month for cognitive development, may indicate future problems, highlighting the need for systematic follow-up of this population.
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