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Published on: January 21, 2021
Executive function and processing speed in Brazilian HIV-infected children and adolescents
Vitor Geraldi Haase1, Nelsa Carol Nicolau2, Virgínia Nunes Viana3
1Faculdade de Filosofia e Ciências Humanas - Universidade Federal de Minas Gerais, Minas Gerais, Brasil.
Insights
Children with vertically transmitted human immunodeficiency virus (HIV) show impaired executive function and processing speed. Antiretroviral therapy did not fully restore neuropsychological performance in these pediatric patients.
Area of Science:
- Neuroscience
- Pediatrics
- Infectious Diseases
Background:
- Cognitive deficits are a known complication in vertically HIV-infected infants and children.
- Early recognition of these disorders is crucial for timely intervention.
Purpose of the Study:
- To assess neuropsychological performance in Brazilian children and adolescents with vertically acquired HIV.
- To evaluate executive function and processing speed in this cohort undergoing antiretroviral therapy.
Main Methods:
- A cohort of 41 vertically HIV-infected children and adolescents (ages 5-17) in Brazil was studied.
- Participants were categorized into mildly symptomatic (CDC class A/B) and advanced disease (CDC class C) groups.
- Neuropsychological tasks focused on executive function and processing speed, compared against typically developing controls.
Main Results:
- HIV-infected children and adolescents performed significantly worse on neuropsychological tests compared to controls.
- Motor and cognitive processing speed, along with executive function, were the most affected domains.
- Individuals with advanced HIV disease showed lower performance and greater variability.
Conclusions:
- Vertically HIV-infected children and adolescents experience significant neuropsychological impairments, particularly in processing speed and executive function.
- While more pronounced in advanced disease stages, these deficits did not strictly correlate with CDC staging.
- Antiretroviral therapy's impact on fully normalizing these cognitive functions requires further investigation.
Background:
Cognitive disorders in infants and children who are vertically infected with human immunodeficiency virus (HIV) have been recognized since the inception of the epidemic.
Objective:
The present study investigated neuropsychological performance in a cohort of vertically infected Brazilian children and adolescents who underwent antiretroviral therapy. The neuropsychological tasks were designed to evaluate executive function and processing speed.
Methods:
Children and adolescents were recruited at a major research and treatment reference center for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV) in Minas Gerais, Brazil. Forty-one individuals aged 5 to 17 years were enrolled. Twelve were mildly symptomatic (HIV-infected group, Centers for Disease Control and Prevention [CDC] class A or B), and 29 had advanced clinical disease (AIDS group, CDC class C).
Results:
The results showed that HIV-infected children and adolescents exhibited lower performance on neuropsychological tasks than sociodemographically comparable, typically developing controls. Motor and cognitive processing speed and executive function appeared to be the most discriminative domains.
Conclusion:
HIV-infected individuals with more-advanced disease stages exhibited lower performance levels and had greater performance heterogeneity on neuropsychological tasks. Thus, the observed neuropsychological impairments, although more pronounced in participants with more advanced stages of the disease, did not correlate with the variable used (CDC stage).
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