Neruodevelopmental Outcomes in Preschool Children Living With HIV-1 Subtypes A and D in Uganda

Horacio Ruiseñor-Escudero, Alla Sikorskii, Itziar Familiar-Lopez, Deborah Persaud, Carrie Ziemniak, Noeline Nakasujja, Robert Opoka, Michael Boivin

Research output: Contribution to journalArticle

Abstract

BACKGROUND: HIV is a neuropathogenic virus that may result in detrimental neurodevelopmental (ND) outcomes early in life. This is the first study to evaluate the effect of HIV-1 subtype on neurodevelopment of Ugandan preschool children. METHODS: Neurodevelopment of 87 HIV-1 infected and 221 HIV exposed uninfected Ugandan children 1.8-4.9 years of age was assessed using 4 scales of the Mullen Scales of Early Learning (MSEL), 2 scales of the Color Object Association Test (COAT), and 1 score of the Early Childhood Vigilance Test. HIV-1 subtype was defined by phylogenetic analyses. General linear models were used to relate test scores to HIV-1 subtype (A versus D) while adjusting for relevant covariates. The scores were benchmarked against HIV exposed uninfected group to facilitate the interpretation. RESULTS: Seventy-one percentage of children infected with subtype A versus 60% of children with subtype D were currently on antiretroviral therapy (P = 0.49). Children with HIV-1 subtype A infection were older when compared with subtype D (3.29 vs. 2.76 years, respectively, P = 0.03), but similar regarding sex, socioeconomic status, weight-for-age z-score, CD4+ and CD8+ (% and total), viral load. No statistically significant differences by HIV-1 subtype were observed in the MSEL, COAT and Early Childhood Vigilance Test. Differences ≥ 0.33 of the SD were observed for the MSEL Composite Score, Receptive Language (MSEL) and Total Memory (COAT). CONCLUSIONS: In contrast to previously reported differences in ND outcomes of school-age children by HIV-1 subtype, ND scores among preschool children were similar for subtypes A and D, with few potential differences on language production and memory outcomes that favored subtype A. Further investigation with larger sample sizes and longitudinal follow-up is needed.

Original languageEnglish (US)
Pages (from-to)e298-e303
JournalThe Pediatric infectious disease journal
Volume37
Issue number12
DOIs
StatePublished - Dec 1 2018

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Uganda
Preschool Children
HIV-1
Learning
Color
HIV
Language
Viral Load
Social Class
Sample Size
Linear Models
Viruses
Weights and Measures
Infection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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Ruiseñor-Escudero, H., Sikorskii, A., Familiar-Lopez, I., Persaud, D., Ziemniak, C., Nakasujja, N., ... Boivin, M. (2018). Neruodevelopmental Outcomes in Preschool Children Living With HIV-1 Subtypes A and D in Uganda. The Pediatric infectious disease journal, 37(12), e298-e303. https://doi.org/10.1097/INF.0000000000002097

Neruodevelopmental Outcomes in Preschool Children Living With HIV-1 Subtypes A and D in Uganda. / Ruiseñor-Escudero, Horacio; Sikorskii, Alla; Familiar-Lopez, Itziar; Persaud, Deborah; Ziemniak, Carrie; Nakasujja, Noeline; Opoka, Robert; Boivin, Michael.

In: The Pediatric infectious disease journal, Vol. 37, No. 12, 01.12.2018, p. e298-e303.

Research output: Contribution to journalArticle

Ruiseñor-Escudero, H, Sikorskii, A, Familiar-Lopez, I, Persaud, D, Ziemniak, C, Nakasujja, N, Opoka, R & Boivin, M 2018, 'Neruodevelopmental Outcomes in Preschool Children Living With HIV-1 Subtypes A and D in Uganda', The Pediatric infectious disease journal, vol. 37, no. 12, pp. e298-e303. https://doi.org/10.1097/INF.0000000000002097
Ruiseñor-Escudero, Horacio ; Sikorskii, Alla ; Familiar-Lopez, Itziar ; Persaud, Deborah ; Ziemniak, Carrie ; Nakasujja, Noeline ; Opoka, Robert ; Boivin, Michael. / Neruodevelopmental Outcomes in Preschool Children Living With HIV-1 Subtypes A and D in Uganda. In: The Pediatric infectious disease journal. 2018 ; Vol. 37, No. 12. pp. e298-e303.
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abstract = "BACKGROUND: HIV is a neuropathogenic virus that may result in detrimental neurodevelopmental (ND) outcomes early in life. This is the first study to evaluate the effect of HIV-1 subtype on neurodevelopment of Ugandan preschool children. METHODS: Neurodevelopment of 87 HIV-1 infected and 221 HIV exposed uninfected Ugandan children 1.8-4.9 years of age was assessed using 4 scales of the Mullen Scales of Early Learning (MSEL), 2 scales of the Color Object Association Test (COAT), and 1 score of the Early Childhood Vigilance Test. HIV-1 subtype was defined by phylogenetic analyses. General linear models were used to relate test scores to HIV-1 subtype (A versus D) while adjusting for relevant covariates. The scores were benchmarked against HIV exposed uninfected group to facilitate the interpretation. RESULTS: Seventy-one percentage of children infected with subtype A versus 60{\%} of children with subtype D were currently on antiretroviral therapy (P = 0.49). Children with HIV-1 subtype A infection were older when compared with subtype D (3.29 vs. 2.76 years, respectively, P = 0.03), but similar regarding sex, socioeconomic status, weight-for-age z-score, CD4+ and CD8+ ({\%} and total), viral load. No statistically significant differences by HIV-1 subtype were observed in the MSEL, COAT and Early Childhood Vigilance Test. Differences ≥ 0.33 of the SD were observed for the MSEL Composite Score, Receptive Language (MSEL) and Total Memory (COAT). CONCLUSIONS: In contrast to previously reported differences in ND outcomes of school-age children by HIV-1 subtype, ND scores among preschool children were similar for subtypes A and D, with few potential differences on language production and memory outcomes that favored subtype A. Further investigation with larger sample sizes and longitudinal follow-up is needed.",
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N2 - BACKGROUND: HIV is a neuropathogenic virus that may result in detrimental neurodevelopmental (ND) outcomes early in life. This is the first study to evaluate the effect of HIV-1 subtype on neurodevelopment of Ugandan preschool children. METHODS: Neurodevelopment of 87 HIV-1 infected and 221 HIV exposed uninfected Ugandan children 1.8-4.9 years of age was assessed using 4 scales of the Mullen Scales of Early Learning (MSEL), 2 scales of the Color Object Association Test (COAT), and 1 score of the Early Childhood Vigilance Test. HIV-1 subtype was defined by phylogenetic analyses. General linear models were used to relate test scores to HIV-1 subtype (A versus D) while adjusting for relevant covariates. The scores were benchmarked against HIV exposed uninfected group to facilitate the interpretation. RESULTS: Seventy-one percentage of children infected with subtype A versus 60% of children with subtype D were currently on antiretroviral therapy (P = 0.49). Children with HIV-1 subtype A infection were older when compared with subtype D (3.29 vs. 2.76 years, respectively, P = 0.03), but similar regarding sex, socioeconomic status, weight-for-age z-score, CD4+ and CD8+ (% and total), viral load. No statistically significant differences by HIV-1 subtype were observed in the MSEL, COAT and Early Childhood Vigilance Test. Differences ≥ 0.33 of the SD were observed for the MSEL Composite Score, Receptive Language (MSEL) and Total Memory (COAT). CONCLUSIONS: In contrast to previously reported differences in ND outcomes of school-age children by HIV-1 subtype, ND scores among preschool children were similar for subtypes A and D, with few potential differences on language production and memory outcomes that favored subtype A. Further investigation with larger sample sizes and longitudinal follow-up is needed.

AB - BACKGROUND: HIV is a neuropathogenic virus that may result in detrimental neurodevelopmental (ND) outcomes early in life. This is the first study to evaluate the effect of HIV-1 subtype on neurodevelopment of Ugandan preschool children. METHODS: Neurodevelopment of 87 HIV-1 infected and 221 HIV exposed uninfected Ugandan children 1.8-4.9 years of age was assessed using 4 scales of the Mullen Scales of Early Learning (MSEL), 2 scales of the Color Object Association Test (COAT), and 1 score of the Early Childhood Vigilance Test. HIV-1 subtype was defined by phylogenetic analyses. General linear models were used to relate test scores to HIV-1 subtype (A versus D) while adjusting for relevant covariates. The scores were benchmarked against HIV exposed uninfected group to facilitate the interpretation. RESULTS: Seventy-one percentage of children infected with subtype A versus 60% of children with subtype D were currently on antiretroviral therapy (P = 0.49). Children with HIV-1 subtype A infection were older when compared with subtype D (3.29 vs. 2.76 years, respectively, P = 0.03), but similar regarding sex, socioeconomic status, weight-for-age z-score, CD4+ and CD8+ (% and total), viral load. No statistically significant differences by HIV-1 subtype were observed in the MSEL, COAT and Early Childhood Vigilance Test. Differences ≥ 0.33 of the SD were observed for the MSEL Composite Score, Receptive Language (MSEL) and Total Memory (COAT). CONCLUSIONS: In contrast to previously reported differences in ND outcomes of school-age children by HIV-1 subtype, ND scores among preschool children were similar for subtypes A and D, with few potential differences on language production and memory outcomes that favored subtype A. Further investigation with larger sample sizes and longitudinal follow-up is needed.

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