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Neurocognitive Lag in School-Aged Children Living With HIV in India and Its Relevance
Vishwanath1, Alok Hemal1, Manju Nimesh1
1Pediatrics, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, IND.
Insights
Pediatric HIV patients show significant neurocognitive lags, particularly older children. Lower CD4 counts correlate with underperformance, indicating intellectual gains decline with age in children living with HIV.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuropsychology
Background:
- Pediatric HIV infection can impact neurodevelopment.
- Understanding neurocognitive outcomes is crucial for managing children living with HIV (CLHIV).
Purpose of the Study:
- To objectively assess neurocognitive lags in school-aged children living with HIV.
- To explore correlations between neurocognitive lag and clinical, social, and familial factors.
Main Methods:
- Ninety-eight school-aged CLHIV (7-18 years) were evaluated using Raven's Standard Progressive Matrices.
- Data on sociodemographics, HIV transmission, clinical stage, CD4 count, and HAART duration were collected.
- Analysis compared well-performing and under-performing groups.
Main Results:
- A significant neurocognitive lag was identified in 29.6% of CLHIV.
- Older children (11-18 years) were disproportionately represented in the under-performing group (P = 0.007).
- Under-performing children had significantly lower mean CD4 counts (P = 0.001).
Conclusions:
- CLHIV experience substantial neurocognitive lags, more pronounced in older children.
- Declining intellectual gains appear associated with increasing age in this population.
- Lower CD4 counts are linked to poorer neurocognitive outcomes.
Abstract:
Objective Objective assessment of neurocognitive lags in pediatric HIV patients and its correlation with various clinical, social and familial factors. Methods Ninety-eight school-aged children living with HIV (CLHIV) (age 7-18 years) attending regional pediatric HIV clinic were observed for neurocognitive lag using Raven's Standard Progressive Matrices by the same trained instructor. Sociodemographic data, mode of transmission, clinical staging, CD4 count, highly active antiretroviral therapy (HAART) duration were recorded and analyzed in the well-performing group and under-performing group. Results 29.6% of children had definitive neurocognitive lag. The proportion of older children (11-18 years) in the under-performing group was significantly high (P = 0.007). The mean CD4 counts were low in the under-performing group (P = 0.001). Other socioeconomic factors could not be specifically correlated with neurocognitive lag in either of the groups. Conclusion CLHIV has a significant neurocognitive lag, which is accentuated in the upper age group. Findings point toward declining intellectual gains with increasing age in CLHIV.
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