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Significant differences between verbal and non-verbal intellectual scales on a perinatally HIV-infected cohort: from
C García-Navarro1,2, S Jimenez de Ory3,4, C Velo Higueras1,2
1Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
Insights
Perinatally HIV-infected children show lower intellectual functioning, particularly in crystallized intelligence, despite effective treatment. Caregiver education is a key factor influencing cognitive outcomes in this population.
Area of Science:
- Neuroscience
- Pediatrics
- Infectious Diseases
Background:
- Perinatally HIV-infected children often experience delayed neurodevelopment.
- Understanding the intellectual profile and influencing factors is crucial for targeted interventions.
Purpose of the Study:
- To assess the intellectual profile of perinatally HIV-infected children.
- To identify socio-environmental and infection-related variables impacting cognitive function.
Main Methods:
- A cross-sectional cohort study of 97 perinatally HIV-infected children in Spain.
- Analysis of intellectual measures, psychosocial data, and HIV-related information.
- Statistical analysis including regression modeling to identify influencing factors.
Main Results:
- The cohort's average crystallized intelligence (CI) and intelligence quotient (IQ) scores were lower than the general population.
- Significant differences were observed between CI and fluid intelligence.
- Higher parental education was strongly associated with better performance across all intelligence scales.
- Caregiver's academic level, age at combination antiretroviral therapy (cART) initiation, and primary language influenced CI.
Conclusions:
- Perinatally HIV-infected children exhibit impaired crystallized intelligence despite good treatment outcomes.
- Cognitive deficits are influenced by both HIV infection and socio-environmental factors.
- Caregiver education is a significant protective factor for cognitive development in this cohort.
Abstract:
Delayed neurodevelopment is a common outcome in perinatally HIV-infected children. Our aim was to assess the intellectual profile of our cohort, considering both the infection and socio-environmental related variables. A cross-sectional cohort study was undertaken at seven major hospitals in Spain belonging to the CoRISpeS cohort (n = 97). Patients were followed up according to a standard protocol. Intellectual measures, psychosocial profile and HIV infection-related data have been analysed. The average patient age was 15 years. The median CD4 cell percentage was 35% (1,59). Viral load was undetectable in 80% of the patients and 27% were on AIDS category; 38% of whom had encephalopathy. The average composite score of both crystallized intelligence (CI) and intelligence quotient (IQ) for the cohort was lower than that of the general population (p < 0.001). Results revealed a significant difference of 38% between crystallized and fluid intelligence. There was a clear association between IQ and age of diagnosis (p = 0.022); CI and CDC classification (p = 0.035), CD4 count (p = 0.011) and CD4 nadir (p = 0.001). Higher parental education was associated with better performance across all intelligence scales (p < 0.002). A regression model showed that CI was influenced by the academic level of caregivers (p = 0.002), age at start of cART (p = 0.050) and primary language (p = 0.058). Findings revealed significant differences in verbal and non-verbal intellectual scales resulting in a misleading IQ Composite score. Crystallized intelligence demonstrated the highest level of impairment despite adequate treatment and good immunovirological status, while fluid intelligence results were average. Caregiver level of education was the strongest factor across all intelligence measures.
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