Neurodevelopment in early treated HIV-infected infants participating in a developmental stimulation programme
Renate Strehlau1, Megan Burke1, Tamryn van Aswegen1
1Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Neurodevelopmental stimulation programs combined with early antiretroviral therapy (ART) significantly improved developmental outcomes in infants with HIV. Early intervention is key for better cognitive and language development in these children.
Area of Science:
- Pediatrics
- Neuroscience
- Infectious Diseases
Background:
- Neurodevelopmental stimulation programs can enhance developmental outcomes in children.
- Early antiretroviral therapy (ART) may limit central nervous system invasion by HIV.
- Combining early ART and developmental stimulation may mitigate developmental delays in perinatally HIV-infected children.
Purpose of the Study:
- To evaluate the impact of a home-based neurodevelopmental stimulation program on the development of HIV-infected neonates receiving early ART.
- To compare developmental outcomes in HIV-infected infants receiving stimulation alongside early ART versus those receiving only early ART.
Main Methods:
- 36 HIV-infected neonates on ART were enrolled in an intervention group (IG) with a yearlong home-based neurodevelopmental stimulation program.
- Bayley Scales of Infant and Toddler Development-3rd Edition (BSID-III) assessments were conducted at 12 months for the IG and compared with 24 infants in an observational group (OG).
- Older children in the OG also underwent BSID-III assessments at 24 or 36 months; cognitive, language, and motor scores were analyzed.
Main Results:
- The intervention group (IG) showed higher BSID-III scaled and composite scores than the observational group (OG), except for gross motor scores.
- Receptive communication scaled scores were significantly higher in the IG (p = 0.0331).
- Older OG children (24-36 months) had lower composite scores across all subscales compared to 12-month OG scores.
Conclusions:
- HIV-infected children receiving early ART and participating in a neurodevelopmental stimulation program demonstrated superior BSID-III scores at 12 months compared to those without the program.
- Early neurodevelopmental intervention is beneficial for improving developmental trajectories in infants with perinatally acquired HIV infection.
Background:
Neurodevelopmental stimulation programmes can improve developmental outcomes. Antiretroviral therapy (ART) started soon after birth potentially limits the invasion of HIV into the central nervous system. A combination of developmental stimulation and early ART initiation may reduce developmental delays in children with perinatally acquired HIV infection.
Methods:
At a single site in Johannesburg, South Africa, we enrolled 36 HIV-infected neonates on ART into an intervention group (IG) participating in a yearlong home-based, neurodevelopmental stimulation programme. Bayley Scales of Infant and Toddler Development-3rd Edition (BSID-III) assessments were conducted at 12 months. Scores were compared with 24 early treated HIV-infected infants in an observational group (OG). BSID-III assessments were also conducted for older children in an OG at 24 or 36 months. Cognitive, language and motor scaled and composite scores were analysed.
Results:
BSID-III scaled and composite scores were all higher in the IG apart from the gross motor scaled score (9.25 vs. 10, p = 0.1954). Receptive communication scaled score was significantly higher in the IG (10.96 vs. 9, p = 0.0331). IG composite scores were all higher than OG scores. OG children assessed at 24 or 36 months had lower composite scores in all subscales than 12-month OG scores.
Conclusions:
Early treated HIV-infected children participating in a neurodevelopmental stimulation programme achieved higher BSID-III scores at 12 months compared with early treated HIV-infected children who did not receive the programme.
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