TY - JOUR
T1 - Neruodevelopmental Outcomes in Preschool Children Living with HIV-1 Subtypes A and D in Uganda
AU - Ruiseñor-Escudero, Horacio
AU - Sikorskii, Alla
AU - Familiar-Lopez, Itziar
AU - Persaud, Deborah
AU - Ziemniak, Carrie
AU - Nakasujja, Noeline
AU - Opoka, Robert
AU - Boivin, Michael
N1 - Funding Information:
Accepted for publication April 7, 2018. From the *Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lancing, MI; †Departments of Pediat-rics, Johns Hopkins Medical Institutions, Baltimore, MD; ‡Makerere University, Department of Psychiatry, Kampala, Uganda; and §Makerere University, Department of Pediatrics, Kampala, Uganda. Clinical Trial Registration: clinicaltrials.gov Identifier NCT01640561. All phases of this study were supported by the National Institutes of Health (NIH) grant# RO1 HD070723. HIV subtyping was supported by the Depart-ment of Psychiatry at Michigan State University. The authors have no conflicts of interest to disclose. Address for correspondence: Horacio Ruisenor-Escudero, PhD, MD, MSc, Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, West Fee Hall, 909 Fee Rd., A322, East Lansing, MI 48824. E-mail: horaciore@gmail.com. Copyright 2018 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0891-3668/18/3712-e298 DOI: 10.1097/INF.0000000000002097
Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/12/1
Y1 - 2018/12/1
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.
KW - HIV subtype
KW - children
KW - neurodevelopment
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U2 - 10.1097/INF.0000000000002097
DO - 10.1097/INF.0000000000002097
M3 - Article
C2 - 29746376
AN - SCOPUS:85056270931
SN - 0891-3668
VL - 37
SP - E298-E303
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 12
ER -