Paulina Coutifaris1, Desiree Byrd1,2,3, Jocelyn Childs4, Uraina Clark1,2, Roberto Posada4, Reuben Robbins5, Susan Morgello1,6,7. 1. Department of Neurology. 2. Department of Psychiatry. 3. Department of Psychology, Queens College and the Graduate Center, City University of New York. 4. Department of Pediatrics. 5. New York State Psychiatric Institute, HIV Center for Clinical and Behavioral Studies, Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA. 6. Department of Pathology. 7. Department of Neuroscience, The Icahn School of Medicine at Mount Sinai.
Abstract
BACKGROUND: With combination antiretroviral therapy (cART), infants with perinatally acquired HIV (pHIV) are living into adolescence and adulthood. Worldwide, many have not received cART in the first years of life, and challenges of adolescence complicate transition to adulthood. Neurobehavioral outcomes in pHIV young adults (pHIVAd) are infrequently reported. OBJECTIVES: To examine neurobehavioral characteristics of pHIVAd ages 21-30 years, and to compare them with age-matched young adults infected in the second or third decade of life (HIVagematch), and older adults with similar duration HIV disease (HIVOA). METHODS: A comprehensive neuropsychological test battery and questionnaires to determine cognitive function and mood, and reviews of neuromedical and behavioral records were undertaken in three groups of 13 individuals each. Descriptive analysis and bivariate techniques were used for comparisons. RESULTS: Rates of cognitive impairment were highest in pHIVAd (85%) compared with HIVagematch (38%) and HIVOA (62%). pHIVAd had the worst scores in global cognition, speed of information processing, working memory, and verbal fluency (0.5--1.0 SD below other groups). There was a trend for higher rates of psychiatric dysfunction (predominantly mood disorders) in pHIVAd (85%) compared with HIV-agematch (46%) and HIVOA (54%). Only four pHIVAd reported employment or enrollment in school. Four had autoimmune disorders. CONCLUSION: These pHIVAd displayed high rates of cognitive, psychiatric, and autoimmune dysfunction, greater than age-matched or HIV duration-matched comparators. Although this small study is largely descriptive in nature, it suggests that a lack of cART in early life may result in long-term neurobehavioral and immune abnormalities manifesting into adulthood.
BACKGROUND: With combination antiretroviral therapy (cART), infants with perinatally acquired HIV (pHIV) are living into adolescence and adulthood. Worldwide, many have not received cART in the first years of life, and challenges of adolescence complicate transition to adulthood. Neurobehavioral outcomes in pHIV young adults (pHIVAd) are infrequently reported. OBJECTIVES: To examine neurobehavioral characteristics of pHIVAd ages 21-30 years, and to compare them with age-matched young adults infected in the second or third decade of life (HIVagematch), and older adults with similar duration HIV disease (HIVOA). METHODS: A comprehensive neuropsychological test battery and questionnaires to determine cognitive function and mood, and reviews of neuromedical and behavioral records were undertaken in three groups of 13 individuals each. Descriptive analysis and bivariate techniques were used for comparisons. RESULTS: Rates of cognitive impairment were highest in pHIVAd (85%) compared with HIVagematch (38%) and HIVOA (62%). pHIVAd had the worst scores in global cognition, speed of information processing, working memory, and verbal fluency (0.5--1.0 SD below other groups). There was a trend for higher rates of psychiatric dysfunction (predominantly mood disorders) in pHIVAd (85%) compared with HIV-agematch (46%) and HIVOA (54%). Only four pHIVAd reported employment or enrollment in school. Four had autoimmune disorders. CONCLUSION: These pHIVAd displayed high rates of cognitive, psychiatric, and autoimmune dysfunction, greater than age-matched or HIV duration-matched comparators. Although this small study is largely descriptive in nature, it suggests that a lack of cART in early life may result in long-term neurobehavioral and immune abnormalities manifesting into adulthood.
Authors: A Antinori; G Arendt; J T Becker; B J Brew; D A Byrd; M Cherner; D B Clifford; P Cinque; L G Epstein; K Goodkin; M Gisslen; I Grant; R K Heaton; J Joseph; K Marder; C M Marra; J C McArthur; M Nunn; R W Price; L Pulliam; K R Robertson; N Sacktor; V Valcour; V E Wojna Journal: Neurology Date: 2007-10-03 Impact factor: 9.910
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: Robert K Heaton; Thomas D Marcotte; Monica Rivera Mindt; Joseph Sadek; David J Moore; Heather Bentley; J Allen McCutchan; Carla Reicks; Igor Grant Journal: J Int Neuropsychol Soc Date: 2004-05 Impact factor: 2.892
Authors: Steven Paul Woods; Julie D Rippeth; Alan B Frol; Joel K Levy; Elizabeth Ryan; Vicki M Soukup; Charles H Hinkin; Deborah Lazzaretto; Mariana Cherner; Thomas D Marcotte; Benjamin B Gelman; Susan Morgello; Elyse J Singer; Igor Grant; Robert K Heaton Journal: J Clin Exp Neuropsychol Date: 2004-09 Impact factor: 2.475
Authors: Vinicius A Vieira; Peter Zuidewind; Maximilian Muenchhoff; Julia Roider; Jane Millar; Margaret Clapson; Anriette Van Zyl; Delane Shingadia; Emily Adland; Rohin Athavale; Nicholas Grayson; M Azim Ansari; Christian Brander; Claudia Fortuny Guash; Lars Naver; Thanyawee Puthanakit; Wipaporn Natalie Songtaweesin; Jintanat Ananworanich; Denise Peluso; Beatriz Thomé; Jorge Pinto; Pieter Jooste; Gareth Tudor-Williams; Mark F Cotton; Philip Goulder Journal: AIDS Date: 2019-01-27 Impact factor: 4.177
Authors: Cory M Hogaboam; Matthew A Schaller; Jennifer R Bermick; Nathalie J Lambrecht; Aaron D denDekker; Steven L Kunkel; Nicholas W Lukacs Journal: Clin Epigenetics Date: 2016-09-20 Impact factor: 6.551
Authors: Jorem Emmillian Awadu; Alla Sikorskii; Sarah Zalwango; Audrey Coventry; Bruno Giordani; Amara E Ezeamama Journal: Int J Environ Res Public Health Date: 2022-03-21 Impact factor: 3.390