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Neurodevelopmental testing of children born to human immunodeficiency virus type 1 seropositive and seronegative
P Msellati1, P Lepage, D G Hitimana
1INSERM U 330, University of Bordeaux II, France.
Insights
Human immunodeficiency virus (HIV)-infected children show more developmental delays in their first two years. This delay is linked to the acquired immunodeficiency syndrome (AIDS) stage of pediatric HIV infection.
Area of Science:
- Pediatric infectious diseases
- Neurodevelopmental disorders
- Global health
Background:
- Human immunodeficiency virus (HIV) infection in children poses significant health challenges.
- Developmental outcomes in children born to HIV-seropositive mothers require careful monitoring.
- Understanding the impact of HIV on early childhood development is crucial for effective interventions.
Purpose of the Study:
- To compare developmental outcomes in HIV-infected children with those of HIV-uninfected children.
- To assess neurodevelopmental trajectories in children during the first two years of life.
- To investigate the relationship between HIV infection, acquired immunodeficiency syndrome (AIDS) stage, and developmental delays.
Main Methods:
- A cohort study in Kigali, Rwanda, involving 218 children born to HIV-seropositive mothers and 218 children born to HIV-seronegative mothers.
- Blind neurodevelopmental examinations assessing gross motor, fine motor, language, and social development at 6, 12, 18, and 24 months.
- Analysis comparing abnormal neurologic examination rates between HIV-infected and HIV-uninfected children, including subgroup analysis excluding children with clinical AIDS.
Main Results:
- HIV-infected children exhibited a higher proportion of abnormal neurologic examinations compared to HIV-uninfected children across all age points (15%-40% vs. <=5%).
- Developmental delay was primarily attributed to significantly lower gross motor scores in HIV-infected children.
- Even after excluding children with clinical AIDS, HIV-infected children showed more frequent abnormal examinations (9%-20%) than their uninfected counterparts.
Conclusions:
- HIV-1-infected children experience more frequent developmental delays within the first two years of life in this African population.
- The observed developmental delay in pediatric HIV infection is associated with the progression to the AIDS stage.
- Early neurodevelopmental monitoring is essential for children affected by HIV.
Objective:
The results of developmental testing of 218 children born to human immunodeficiency virus (HIV)-seropositive mothers and infected or uninfected themselves were compared with those of 218 children born to HIV-seronegative mothers in an ongoing cohort study in Kigali, Rwanda.
Methods:
When the children were 6, 12, 18, and 24 months of age, a specific neurodevelopmental examination was performed blindly by study physicians assessing gross motor development, fine motor development, language acquisition, and social contacts.
Results:
Only one acute severe HIV-related encephalopathy was identified among the 50 infected children. The proportion of abnormal neurologic examinations in HIV-infected children varied from 15% to 40% according to age and was always higher than in HIV-uninfected children born to HIV-seropositive and seronegative mothers (< or = 5% or less of abnormal examinations at each time period). After excluding those children with clinical acquired immunodeficiency syndrome (AIDS) from the analysis, the proportion of abnormal examinations in infected children was 12.5% at 6 months, 16% at 12 months, 20% at 18 months, and 9% at 24 months of age and was still more frequent than in HIV-uninfected children. The developmental delay was principally due to significantly lower gross motor scores.
Conclusions:
HIV-1-infected children are more frequently developmentally delayed than uninfected children during the first 2 years of life in this African population. This developmental delay is related to the AIDS stage of pediatric HIV infection.