In:
JAIDS Journal of Acquired Immune Deficiency Syndromes, Ovid Technologies (Wolters Kluwer Health), Vol. 91, No. 2 ( 2022-10-1), p. 217-225
Abstract:
To describe longitudinal outcomes and predictors of cognitive outcomes in children with HIV in Zambia. Background: Multiple studies have shown that children with HIV are at risk for impaired cognition. However, there are limited data on longitudinal cognitive outcomes in children with HIV. Methods: We conducted a prospective cohort study of 208 perinatally infected children with HIV ages 8–17 years, all treated with antiretroviral therapy, and 208 HIV-exposed uninfected controls. Participants were followed for 2 years. Cognition was assessed with a custom NIH Toolbox Cognition Battery, and tests were combined to generate a Summary Cognition Score (SCS). The contribution of potential risk factors to outcomes was explored using regression models and group-based trajectory modeling. Results: HIV was strongly associated with lower SCS at baseline [β-14, 95% confidence interval (CI): −20 to −7, P 〈 0.001]. Change scores over time were similar between groups, but poorer average performance in children with HIV persisted at the 2-year follow-up visit (adjusted β = −11, 95% CI: −22 to −0.3, P = 0.04). Other than HIV, the strongest predictors of baseline SCS included socioeconomic status index (β =3, 95% CI: 1, 5, P = 0.004), history of growth stunting (β=−14, 95% CI: −23 to −6, P = 0.001), history of CD4 count below 200 (β = −19, 95% CI: −35 to −2, P = 0.02), and history of World Health Organization stage 4 disease (β = −10, 95% CI: −19 to −0.2, P = 0.04). In the group-based trajectory model, HIV+ status predicted membership in the lowest performing trajectory group (odds ratio 2.5, 95% CI: 1.2 to 5.1, P = 0.01). Conclusions: Children with HIV are at risk of poor cognitive outcomes, despite chronic treatment with antiretroviral therapy.
Type of Medium:
Online Resource
ISSN:
1525-4135
DOI:
10.1097/QAI.0000000000003052
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2038673-4
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