African multi-site 2-year neuropsychological study of school-age children perinatally infected, exposed, and unexposed to human immunodeficiency virus

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dc.contributor.authorBoivin, Michael J.en_ZA
dc.contributor.authorChernoff, Miriamen_ZA
dc.contributor.authorFairlie, Leeen_ZA
dc.contributor.authorLaughton, Barbaraen_ZA
dc.contributor.authorZimmer, Bonnieen_ZA
dc.contributor.authorJoyce, Celesteen_ZA
dc.contributor.authorBarlow-Mosha, Lindaen_ZA
dc.contributor.authorBwakura-Dangarembizi, Mutsawasheen_ZA
dc.contributor.authorVhembo, Tichaonaen_ZA
dc.contributor.authorRatswana, Mmuleen_ZA
dc.contributor.authorKamthunzi, Portiaen_ZA
dc.contributor.authorMcCarthy, Katieen_ZA
dc.contributor.authorFamiliar-Lopez, Itziaren_ZA
dc.contributor.authorJean-Philippe, Patricken_ZA
dc.contributor.authorCoetzee, Joanen_ZA
dc.contributor.authorAbrahams, Nasreenen_ZA
dc.contributor.authorGous, Hermienen_ZA
dc.contributor.authorViolari, Avyen_ZA
dc.contributor.authorCotton, Mark F.en_ZA
dc.contributor.authorPalumbo, Paul E.en_ZA
dc.date.accessioned2022-06-01T07:52:09Zen_ZA
dc.date.available2022-06-01T07:52:09Zen_ZA
dc.date.issued2020-10en_ZA
dc.descriptionCITATION: Boivin, M. J. et al. 2020. African Multi-Site 2-Year Neuropsychological Study of School-Age Children Perinatally Infected, Exposed, and Unexposed to Human Immunodeficiency Virus. Clinical infectious diseases, 71(7): e105–e114. doi:10.1093/cid/ciz1088en_ZA
dc.descriptionThe original publication is available at https://academic.oup.com/cid/en_ZA
dc.description.abstractBackground Children living with human immunodeficiency virus (HIV) are at neuropsychological risk for cognitive and motor dysfunction. However, few prospective, multi-site studies have evaluated neuropsychological outcomes longitudinally among perinatally infected African children who received early antiretroviral treatment (ART). Methods We enrolled 611 children aged 5 to 11 years at 6 sites (South Africa [3], Zimbabwe, Malawi, Uganda). Of these, there were 246 children living with HIV (HIV+) who were initiated on ART before 3 years of age in a prior clinical trial comparing nevirapine to lopinavir/ritonavir (International Maternal Pediatric Adolescent Acquired Immunodeficiency Syndrome Clinical Trials [IMPAACT] P1060); 183 age-matched, exposed but uninfected (HEU) children; and 182 unexposed and uninfected (HUU) children. They were compared across 3 assessment time points (Weeks 0, 48, and 96) on cognitive ability (Kaufman Assessment Battery for Children, second edition [KABC-II]), attention/impulsivity (Tests of Variables of Attention [TOVA]), motor proficiency (Bruininks-Oseretsky Test, second edition [BOT-2]), and on the Behavior Rating Inventory of Executive Function (BRIEF). The cohorts were compared using linear mixed models, adjusting for site, child’s age and sex, and selected personal/family control variables. Results The HIV+ cohort performed significantly worse than the HEU and HUU cohorts for all KABC-II, TOVA, and BOT-2 performance outcomes across all 3 time points (P values < .001). The HUU and HEU cohorts were comparable. For the KABC-II planning/reasoning subtests, the HIV+ children showed less improvement over time than the HUU and HEU groups. The groups did not differ significantly on the BRIEF. Conclusions Despite initiation of ART in early childhood and good viral suppression at the time of enrollment, the HIV+ group had poorer neuropsychological performance over time, with the gap progressively worsening in planning/reasoning. This can be debilitating for self-management in adolescence.en_ZA
dc.description.urihttps://academic.oup.com/cid/article/71/7/e105/5649306?login=trueen_ZA
dc.description.versionPublishers versionen_ZA
dc.format.extent10 pagesen_ZA
dc.identifier.citationBoivin, M. J. et al. 2020. African Multi-Site 2-Year Neuropsychological Study of School-Age Children Perinatally Infected, Exposed, and Unexposed to Human Immunodeficiency Virus. Clinical infectious diseases, 71(7): e105–e114. doi:10.1093/cid/ciz1088en_ZA
dc.identifier.issn1537-6591 (online)en_ZA
dc.identifier.issn1058-4838 (print)en_ZA
dc.identifier.otherdoi:10.1093/cid/ciz1088en_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/125288en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherOxford University Pressen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectPediatric HIVen_ZA
dc.subjectLearningen_ZA
dc.subjectExecutive functionen_ZA
dc.subjectMotor proficiencyen_ZA
dc.subjectNeuropsychologyen_ZA
dc.titleAfrican multi-site 2-year neuropsychological study of school-age children perinatally infected, exposed, and unexposed to human immunodeficiency virusen_ZA
dc.typeArticleen_ZA
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