TY - JOUR
T1 - Increased Risk of Executive Function and Emotional Behavioral Problems among Virologically Well-Controlled Perinatally HIV-Infected Adolescents in Thailand and Cambodia
AU - Kerr, Stephen J.
AU - Puthanakit, Thanyawee
AU - Malee, Kathleen M.
AU - Thongpibul, Kulvadee
AU - Ly, Penh Sun
AU - Sophonphan, Jiratchaya
AU - Suwanlerk, Tulathip
AU - Kosalaraksa, Pope
AU - Ounchanum, Pradthana
AU - Aurpibul, Linda
AU - Kanjanavanit, Suparat
AU - Ngampiyaskul, Chaiwat
AU - Chettra, Kea
AU - Robbins, Reuben
AU - Paul, Robert
AU - Ananworanich, Jintanat
AU - Mellins, Claude A.
N1 - Funding Information:
Supported by the U.S. National Institute of Allergy and Infectious Diseases (U19 AI053741) and the U.S. National Institute of Mental Health (R01MH089722 and R01MH102151). Antiretroviral drugs for PREDICT were provided by ViiV Healthcare (AZT, 3 TC), Boehringer Ingelheim (NVP), Merck (EFV), Abbott (RTV), and Roche (NFV).
Funding Information:
Supported by the U.S. National Institute of Allergy and Infectious Diseases (U19 AI053741) and the U.S. National Institute of Mental Health (R01MH089722 and R01MH102151). Antiretroviral drugs for PREDICT were provided by ViiV Healthcare (AZT, 3 TC), Boehringer Ingelheim (NVP), Merck (EFV), Abbott (RTV), and Roche (NFV).
Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Background:Large numbers of perinatally HIV-infected (PHIV) children are aging into adolescence. We examined cognitive and behavioral outcomes in a longitudinal cohort of Asian youth.Methods:We followed up 231 PHIV, 125 perinatally HIV-exposed, uninfected (HEU), and 138 HIV-unexposed, uninfected (HUU) adolescents (aged 10 years and older), matched by age/sex, in Thailand and Cambodia for 3 years. Executive function was assessed with Children's Color Trails Tests 1 and 2 (CCTT-1 and -2), the design fluency test, and the verbal fluency test. Working memory (Freedom from Distractibility Index) and processing speed index were assessed using WISC-III. Visual memory was assessed by design memory and design recognition subtests of the Wide Range Assessment of Memory and Learning (WRAML-2) and behavioral problems using the Child Behavior Checklist (CBCL). Generalized estimating equations examined adjusted odds ratios of cognitive impairment (Z-scores ≥2 SD below age-adjusted means of the HUU group) and CBCL T-scores in the borderline-clinical range (T-Scores ≥60) in PHIV and HEU versus HUU youth, adjusting for ethnicity, household income, and caregiver characteristics.Results:The median age at enrollment was 13.8 years, with 58% women and 63% Thai participants. PHIV youth had >86% virological suppression and significantly higher impairment rates on CCTT-1 and -2 tests, design fluency test, verbal fluency tests, design memory, and CBCL internalizing and externalizing problems. Results were mostly similar between HEU and HUU groups, apart from higher impairment rates on CCTT-1 and internalizing problems in HEU.Conclusion:Asian adolescents with PHIV remain at risk of cognitive and mental health problems despite HIV treatment. Selective risks are observed among HEU youth.
AB - Background:Large numbers of perinatally HIV-infected (PHIV) children are aging into adolescence. We examined cognitive and behavioral outcomes in a longitudinal cohort of Asian youth.Methods:We followed up 231 PHIV, 125 perinatally HIV-exposed, uninfected (HEU), and 138 HIV-unexposed, uninfected (HUU) adolescents (aged 10 years and older), matched by age/sex, in Thailand and Cambodia for 3 years. Executive function was assessed with Children's Color Trails Tests 1 and 2 (CCTT-1 and -2), the design fluency test, and the verbal fluency test. Working memory (Freedom from Distractibility Index) and processing speed index were assessed using WISC-III. Visual memory was assessed by design memory and design recognition subtests of the Wide Range Assessment of Memory and Learning (WRAML-2) and behavioral problems using the Child Behavior Checklist (CBCL). Generalized estimating equations examined adjusted odds ratios of cognitive impairment (Z-scores ≥2 SD below age-adjusted means of the HUU group) and CBCL T-scores in the borderline-clinical range (T-Scores ≥60) in PHIV and HEU versus HUU youth, adjusting for ethnicity, household income, and caregiver characteristics.Results:The median age at enrollment was 13.8 years, with 58% women and 63% Thai participants. PHIV youth had >86% virological suppression and significantly higher impairment rates on CCTT-1 and -2 tests, design fluency test, verbal fluency tests, design memory, and CBCL internalizing and externalizing problems. Results were mostly similar between HEU and HUU groups, apart from higher impairment rates on CCTT-1 and internalizing problems in HEU.Conclusion:Asian adolescents with PHIV remain at risk of cognitive and mental health problems despite HIV treatment. Selective risks are observed among HEU youth.
KW - HIV
KW - executive function
KW - mental health
KW - perinatally infected youth
UR - http://www.scopus.com/inward/record.url?scp=85073182781&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073182781&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000002132
DO - 10.1097/QAI.0000000000002132
M3 - Article
C2 - 31335589
AN - SCOPUS:85073182781
SN - 1525-4135
VL - 82
SP - 297
EP - 304
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -
