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Neurocognition in Viral Suppressed HIV-Infected Children

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Global Virology II - HIV and NeuroAIDS

Abstract

In the era of combination antiretroviral therapy (ART), children and adolescents with perinatally acquired HIV (PHIV) infection remain at risk for subtle to severe neurocognitive deficits. Early ART initiation in infancy may mitigate global or selective deficits, likely due to viral suppression; however, youth with PHIV who initiate ART later in childhood are less likely to demonstrate normal neurocognition after ART initiation. The presence of neurocognitive deficits and/or the lack of neurocognitive improvement after ART initiation in older children may be due to damage associated with prior immunosuppression, intermittent periods of HIV replication and neuroinflammation during formative years, and/or ART-associated neurotoxicities. The literature supports the need for early ART initiation during infancy, not only for survival benefit but also for optimizing short-term neurodevelopmental outcomes. However, prospective, longitudinal studies remain necessary to determine the long-term neurocognitive outcomes among children with variably timed viral suppression as well as the functional impact of deficits and potential resilience.

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Author information

Authors and Affiliations

  1. University of Washington School of Medicine, Seattle Children’s Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA

    Claudia S. Crowell MD, MPH

  2. Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 East Chicago Avenue, Box 155, Chicago, IL, 60611, USA

    Kathleen Malee PhD

Authors
  1. Claudia S. Crowell MD, MPH
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  2. Kathleen Malee PhD
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Corresponding author

Correspondence to Claudia S. Crowell MD, MPH .

Editor information

Editors and Affiliations

  1. Department of Internal Medicine, Division of Infectious Diseases and International Health, University of South Florida, Tampa, Florida, USA

    Paul Shapshak

  2. Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA

    Andrew J. Levine

  3. Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico, USA

    Brian T. Foley

  4. Department of Internal Medicine, Division of Infectious Diseases and International Health, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA

    Charurut Somboonwit

  5. Department of Neurology, UCLA David Geffen School of Medicine, Los Angeles, California, USA

    Elyse Singer

  6. Department of Oral Biology and Medicine, UCLA School of Dentistry, Los Angeles, California, USA

    Francesco Chiappelli

  7. Department of Internal Medicine, Division of Infectious Diseases and International Health, University of South Florida, Morsani College of Medicine, Tampa, Florida, USA

    John T. Sinnott

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Crowell, C.S., Malee, K. (2017). Neurocognition in Viral Suppressed HIV-Infected Children. In: Shapshak, P., et al. Global Virology II - HIV and NeuroAIDS. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-7290-6_11

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