OBJECTIVES: To assess the impact of combination antiretroviral therapy on neurocognitive outcomes in perinatally human immunodeficiency virus (HIV)-infected patients and to determine if CD4 percentage and plasma HIV-1 RNA level (viral load) are predictive of future neurocognitive function. DESIGN: Retrospective cohort study. SETTING: An HIV-dedicated urban care center. PARTICIPANTS: One hundred forty-six perinatally HIV-infected children born between June 1990 and May 2003 with at least 1 neurocognitive evaluation. MAIN OUTCOME MEASURES: Neurocognitive standard testing scores as well as diagnosis of progressive encephalopathy, probable progressive encephalopathy, or static encephalopathy. RESULTS: The prevalence of progressive encephalopathy has decreased in children born prior to 1996 (period 1) compared with those born after 1996 (period 2) from 29.6% to 12.1% (P = .049). The prevalence of all progressive encephalopathy and static encephalopathy decreased from 40.7% to 18.2% in period 1 vs 2 (P = .02). For those diagnosed as neurocognitively healthy, neurocognitive scores remained stable over time with a mean (SD) standard score of 89.6 (11.8) at first evaluation compared with 91.9 (11.93) at most recent evaluation. The most recent mean (SD) standard score increased from 82.3 (18) to 87.2 (10.49) in period 1 vs period 2 (P = .001). A weak association was found between both the mean viral load (P = .06) and CD4 percentage (P<.001) and neurocognitive testing score 6 months later. CONCLUSIONS: Since 1996, fewer children have been diagnosed with progressive encephalopathy, and neurocognitive functioning is preserved over time in those deemed neurocognitively healthy at entry. Viral load and CD4 percentage are marginally predictive of future changes in neurocognitive standard scores. These data support the observation that combination antiretroviral therapy is associated with improved neurocognitive outcomes in children with perinatally acquired HIV infection.
OBJECTIVES: To assess the impact of combination antiretroviral therapy on neurocognitive outcomes in perinatally human immunodeficiency virus (HIV)-infectedpatients and to determine if CD4 percentage and plasma HIV-1 RNA level (viral load) are predictive of future neurocognitive function. DESIGN: Retrospective cohort study. SETTING: An HIV-dedicated urban care center. PARTICIPANTS: One hundred forty-six perinatally HIV-infectedchildren born between June 1990 and May 2003 with at least 1 neurocognitive evaluation. MAIN OUTCOME MEASURES: Neurocognitive standard testing scores as well as diagnosis of progressive encephalopathy, probable progressive encephalopathy, or static encephalopathy. RESULTS: The prevalence of progressive encephalopathy has decreased in children born prior to 1996 (period 1) compared with those born after 1996 (period 2) from 29.6% to 12.1% (P = .049). The prevalence of all progressive encephalopathy and static encephalopathy decreased from 40.7% to 18.2% in period 1 vs 2 (P = .02). For those diagnosed as neurocognitively healthy, neurocognitive scores remained stable over time with a mean (SD) standard score of 89.6 (11.8) at first evaluation compared with 91.9 (11.93) at most recent evaluation. The most recent mean (SD) standard score increased from 82.3 (18) to 87.2 (10.49) in period 1 vs period 2 (P = .001). A weak association was found between both the mean viral load (P = .06) and CD4 percentage (P<.001) and neurocognitive testing score 6 months later. CONCLUSIONS: Since 1996, fewer children have been diagnosed with progressive encephalopathy, and neurocognitive functioning is preserved over time in those deemed neurocognitively healthy at entry. Viral load and CD4 percentage are marginally predictive of future changes in neurocognitive standard scores. These data support the observation that combination antiretroviral therapy is associated with improved neurocognitive outcomes in children with perinatally acquired HIV infection.
Authors: Patricia A Garvie; Bret Zeldow; Kathleen Malee; Sharon L Nichols; Renee A Smith; Megan L Wilkins; Paige L Williams Journal: Pediatr Infect Dis J Date: 2014-09 Impact factor: 2.129
Authors: Kevin Robertson; Kathy Kopnisky; James Hakim; Concepta Merry; Noeline Nakasujja; Colin Hall; Moussa Traore; Ned Sacktor; David Clifford; Charles Newton; Annelies Van Rie; Penny Holding; Janice Clements; Christine Zink; Jens Mielk; Mina Hosseinipour; Umesh Lalloo; Farida AMod; Christina Marra; Scott Evans; Jeff Liner Journal: J Neurovirol Date: 2008-04 Impact factor: 2.643
Authors: Reuben N Robbins; R Zimmerman; R Korich; J Raymond; C Dolezal; C J Choi; C S Leu; N Nguyen; K Malee; A Wiznia; E J Abrams; C A Mellins Journal: AIDS Care Date: 2019-06-07
Authors: Heena Brahmbhatt; Michael Boivin; Victor Ssempijja; Joseph Kagaayi; Godfrey Kigozi; David Serwadda; Avy Violari; Ronald H Gray Journal: J Acquir Immune Defic Syndr Date: 2017-05-01 Impact factor: 3.731