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Neurocognitive Development in Perinatally Human Immunodeficiency Virus-infected Adolescents on Long-term Treatment,

Malon Van den Hof1, Anne Marleen Ter Haar1, Henriette J Scherpbier1

  • 1Pediatric Infectious Diseases, University of Amsterdam, The Netherlands.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|May 21, 2019
PubMed

Insights

Perinatally HIV-infected adolescents on combination antiretroviral therapy (cART) showed similar cognitive development to HIV-negative peers over time. However, executive functioning declined more in the HIV-positive group, possibly due to earlier brain damage.

Area of Science:

  • Neuroscience
  • Pediatrics
  • Infectious Diseases

Background:

  • Perinatally human immunodeficiency virus (HIV)-infected adolescents on combination antiretroviral therapy (cART) may experience cognitive impairment.
  • Previous cross-sectional studies indicated significant cognitive differences between HIV-positive (PHIV+) and HIV-negative (HIV-) adolescents.

Purpose of the Study:

  • To longitudinally compare cognitive development trajectories in PHIV+ adolescents receiving cART versus HIV-negative controls.
  • To identify factors influencing cognitive changes over time in this cohort.

Main Methods:

  • A longitudinal study repeating cognitive assessments after a mean of 4.6 years in PHIV+ and HIV- adolescents.
  • Linear mixed models were used to compare cognitive trajectories in intelligence quotient (IQ), processing speed, working memory, executive functioning, learning, and visual-motor function.
  • Multivariate normative comparison (MNC) assessed the prevalence of cognitive impairment.

Main Results:

  • While IQ scores increased more in PHIV+ participants, their executive functioning significantly decreased compared to HIV- controls.
  • Significant differences in executive functioning emerged over time between the groups.
  • No significant differences in trajectories for processing speed, working memory, learning, or visual-motor function were observed.

Conclusions:

  • cART-treated PHIV+ adolescents exhibit comparable global cognitive development to HIV-negative peers over time.
  • A diverging trajectory in executive functioning among PHIV+ adolescents suggests potential long-term effects, possibly linked to earlier neurological impact of HIV.
Abstract

Keywords:
HIVadolescentscognitionexecutive functioninglongitudinal

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