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Published on: November 20, 2015
Perinatal HIV exposure and infection and child executive function
Sarah Brewer1, Nicole Talge1, Claudia Holzman1
1Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
Insights
Children perinatally exposed to human immunodeficiency virus (HIV) show similar executive function (EF) to unexposed peers. Children with HIV infection (CPHIV) demonstrated better behavioral regulation, suggesting they can thrive despite perinatal HIV exposure.
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.
Abstract:
ABSTRACTIn the combined antiretroviral therapy era, limited information exists about cognitive function in children exposed perinatally to human immunodeficiency virus (HIV). To address this, we evaluated executive function (EF) among groups with known HIV exposure status during the perinatal period and at ages 6-10 years: children HIV-infected perinatally (CPHIV, n = 99), children born to HIV-infected mothers, but were HIV negative at enrollment (CPHEU, n = 97), and HIV unexposed, uninfected community controls (CHUU, n = 98). Caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF) to assess two dimensions of child EF (BRI: Behavioral Regulation Index; MCI: Metacognition Index) and a combination of these dimensions (General Executive Composite). We derived Z-scores for BRIEF measures using the CHUU group as the reference and used generalized linear models to estimate mean differences among the groups. The CPHIV and CPHEU groups did not differ from the CHUU group on the GEC or MCI. However, the CPHIV group scored lower than CHUU on the BRI, which is indicative of better functioning in this domain (β = -0.40, 95% CI -0.77, -0.03). Results were unaffected following adjustment. EF scores did not differ substantially across perinatal HIV exposure groups, though we observed evidence that CPHIV may thrive in the BRI domain.
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