期刊
PEDIATRIC INFECTIOUS DISEASE JOURNAL
卷 33, 期 11, 页码 1128-1133出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/INF.0000000000000410
关键词
HIV; ARV; neurodevelopment; children; cognition; academic achievement
资金
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- National Institute on Drug Abuse
- National Institute of Allergy and Infectious Diseases
- Office of AIDS Research
- National Institute of Mental Health
- National Institute of Neurological Disorders and Stroke
- National Institute on Deafness and Other Communication Disorders
- National Heart Lung and Blood Institute
- National Institute of Dental and Craniofacial Research
- National Institute on Alcohol Abuse and Alcoholism
- Harvard University School of Public Health [HD052102, 3 U01 HD052102-05S1, 3 U01 HD052102-06S3]
- Tulane University School of Medicine [HD052104, 3U01HD052104-06S1]
Background: Long-term effects of in utero and neonatal antiretroviral (ARV) exposure on cognitive and academic development in HIV-exposed, uninfected school-age children are unknown. Methods: HIV-exposed, uninfected children, ages 5-13 years, in Pediatric HIV/AIDS Cohort Study Surveillance Monitoring for Antiretroviral Treatment Toxicities, a US-based multisite cohort study, completed age-appropriate Wechsler intelligence and academic scales (WPPSI-III, WASI, WIAT-II-A). Associations between cognitive and academic outcomes and in utero ARV exposure by regimen, class and individual ARVs were evaluated, adjusting for potential confounders. Results: Children completing WPPSI-IIIs (n = 350) were 49% male, 74% Black, 25% Hispanic; WASI (n = 337) and WIAT-II-A (n = 415) cohorts were similar. The percentage exposed to combination ARV (cARV) was 84% (WPPSI-III), 64% (WASI) and 67% (WIAT-II-A). Among ARV-exposed children, there were no significant associations between any ARV regimen or class and any cognitive or academic outcome. In addition, in both unadjusted models and after adjustment for caregiver IQ, sociodemographic factors and maternal health and substance use during pregnancy, no individual ARV drug was associated with significantly lower cognitive or academic scores. Factors typically associated with lower cognitive and academic scores in the general population, such as prematurity, small for gestational age, maternal alcohol use and lower maternal cognitive status, were also associated with lower scores in this study. Conclusions: Overall, the safety of prenatal and neonatal ARV use was supported.
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