Effects of Perinatal HIV Infection on the Cognitive Development of Young Children

In the current study, published in the March 2006 issue of Pediatrics, researchers of the Women and Infants Transmission Study Group examined the effect of HIV, in combination with other important health and social factors, on the development of cognitive abilities of children exposed to HIV before or during birth.

Cognitive assessments were performed for 117 children who were infected vertically and 422 children who were exposed to but not infected with HIV, in a multicenter, natural history, longitudinal study. Repeated-measures analyses were used to evaluate the neurocognitive development of children between the ages of 3 and 7 years, as measured by the McCarthy Scales of Children's Abilities (MSCA).

Results

Children with HIV infection and class C status scored significantly lower in all domains of cognitive development, across all time points, than did those who were HIV-infected without an AIDS-defining illness and those who were HIV exposed but not infected.

There were no significant differences between the 2 latter groups in General Cognitive Index or specific domain scores.

Rates of change in cognitive development were comparable (parallel) among all 3 groups over a period of 4 years.

Factors that were associated consistently and significantly with lower mean scores were HIV status, number of times an examination had been completed previously, primary language, maternal education, and gender.

No factors were related to rate of change of any mean domain score.

"An early AIDS-defining illness increased the risk of chronic static encephalopathy during the preschool and early school age years," conclude the study authors. In addition, they write, "Children with HIV infection but no class C event performed as well as non-infected children in measures of general cognitive ability."

The authors found no significantly different profiles of strengths and weaknesses for verbal, perceptual-performance, quantitative, or memory functioning among children with or without HIV infection.

Finally, the authors note, "A number of factors were found to have significant effects on the mean scores of children in all 3 groups; however, they were not related to the rate at which learning occurred."

04/18/06

Reference
R Smith, K Malee, R Leighty, and others (for the Women and Infants Transmission Study Group). Effects of Perinatal HIV Infection and Associated Risk Factors on Cognitive Development among Young Children. Pediatrics 117(3): 851-862. March 2006.