Perinatal HIV exposure and infection and child executive function.

Area of Science:

• Pediatric infectious diseases
• Neuropsychology
• Child development

Background:

• Limited data exists on cognitive function in children exposed to human immunodeficiency virus (HIV) during the combined antiretroviral therapy era.
• Executive function (EF) is crucial for adaptive functioning in children.

Purpose of the Study:

• To evaluate executive function (EF) in children with varying perinatal HIV exposure statuses.
• To compare EF between perinatally HIV-infected children (CPHIV), HIV-exposed but uninfected children (CPHEU), and HIV-unexposed, uninfected controls (CHUU).

Main Methods:

• Caregiver-reported Behavior Rating Inventory of Executive Function (BRIEF) was used to assess EF.
• Two dimensions (Behavioral Regulation Index [BRI], Metacognition Index [MCI]) and a General Executive Composite (GEC) were analyzed.
• Generalized linear models compared EF scores across the three groups, using CHUU as the reference.

Main Results:

• CPHIV and CPHEU groups did not significantly differ from CHUU on GEC or MCI.
• CPHIV group showed significantly better functioning on the BRI compared to CHUU (β = -0.40).
• Adjusted analyses confirmed these findings, indicating no substantial EF differences across groups, with CPHIV potentially excelling in BRI.

Conclusions:

• Perinatal HIV exposure, even with infection, does not appear to broadly impair executive function in children.
• Children with perinatally acquired HIV may exhibit strengths in behavioral regulation.
• Further research is warranted to understand the nuances of cognitive development in this population.