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Early neurodevelopmental growth in children with vertically transmitted human immunodeficiency virus infection
C Chase1, M Vibbert, S I Pelton
1Department of Pediatrics, University School of Medicine, Boston City Hospital, Mass., USA.
Insights
Children with vertically transmitted human immunodeficiency virus (HIV) infection show early motor delays and later mental development deceleration. Neurodevelopmental outcomes vary significantly among these children.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Developmental Psychology
Background:
- Vertical transmission of human immunodeficiency virus (HIV) can impact child development.
- Understanding neurodevelopmental trajectories in HIV-infected children is crucial for early intervention.
Purpose of the Study:
- To assess mental and motor development in vertically HIV-infected children during their first 30 months of life.
- To compare developmental outcomes between HIV-infected children and HIV-exposed but uninfected controls.
Main Methods:
- A prospective longitudinal study was conducted.
- Twenty-four vertically HIV-infected children and 27 HIV-exposed, uninfected children were assessed using the Bayley Scales of Infant Development at two age spans (4-16 months and 17-30 months).
Main Results:
- Children with HIV infection exhibited persistent delays in motor development across both age spans.
- While mental development was comparable initially, HIV infection was associated with a delay in mental development between 17 and 30 months.
- Motor development remained stable over time in both groups.
Conclusions:
- Early, persistent motor delays and later mental development deceleration characterize many vertically HIV-infected children.
- Significant variability exists in early neurodevelopmental outcomes among children with HIV infection.
- These findings highlight the importance of monitoring neurodevelopment in this population.
Objective:
To examine mental and motor development in children with vertically transmitted human immunodeficiency virus (HIV) infection in the first 30 months of life.
Design:
Prospective longitudinal study comparing two groups: children with HIV infection and HIV-exposed but uninfected children.
Setting:
Pediatric Immunodeficiency Clinic at Boston (Mass) City Hospital, Boston University Medical Center.
Study Participants:
Twenty-four children with vertically transmitted HIV infection and 27 children who were born to HIV-infected mothers and became HIV negative served as controls. Socioeconomic status, gestational age, and prenatal drug exposure were comparable in the two groups.
Measurements/Results:
Using the Bayley Scales of Infant Development, all children were assessed at least once between 4 and 16 months and again between 17 and 30 months of age. Individual mean mental and motor scores were calculated for the early and later age span. Motor development in the infected group was delayed in comparison to the seroreverter group in both age spans and remained stable in both groups over time. Mental development was comparable in the two groups at 4 to 17 months, but HIV infection was associated with delay in mental development at 17 to 30 months of age.
Conclusion:
Early and persistent delay in motor development and deceleration in mental development in late infancy distinguishes many children who are HIV infected from exposed but uninfected children, but there is significant variability in early neurodevelopmental outcome among children with HIV infection.