Encyclopedia of AIDS

Living Edition
| Editors: Thomas J. Hope, Douglas Richman, Mario Stevenson

Neurocognitive Outcomes in HIV-Infected Children and Adolescents

Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-9610-6_221-1

Introduction

Perinatally acquired HIV (PAH) infection was first described in 1981. Within a short time, it became clear that, as with adults, PAH could lead to devastating central nervous system damage in infants and children. Through the early years of the epidemic it also became clear that many infected infants had more subtle static neurocognitive deficits and behavioral disorders.

With the advent of effective antiretroviral therapies and earlier initiation of therapy for infected children, the incidence of more serious HIV-related neurocognitive effects decreased dramatically, and they are rarely seen today. In regions with access to effective pediatric antiretroviral therapy (ART), the vast majority of youth with PAH have learning and behavioral profiles similar to age and sociodemographically matched uninfected youth. With the ability now to achieve lifelong control of the infection, the hope is to develop treatment strategies that best ensure optimal long-term neurocognitive and...

Keywords

Fatigue Toxicity Depression Cocaine Prednisone 
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References

  1. Belman AL, Ultmann MH, Horoupian D, Novick B, Spiro AJ, et al. Neurological complications in infants and children with acquired immune deficiency syndrome. Ann Neurol. 1985;18:560–6.CrossRefPubMedGoogle Scholar
  2. Cotton MF, Violari A, Otwombe K, Panchia R, Dobbels E., Rabie H, … CHER Study Team. Early time-limited antiretroviral therapy versus deferred therapy in South African infants infected with HIV: results from the children with HIV early antiretroviral (CHER) randomised trial. Lancet. 2013;382:1555–63.Google Scholar
  3. Crowell CS, Yanling H, Tassiopoulos K, Malee KM, Yogev R, et al. … Pediatric HIV/AIDS Cohort Study (PHACS). Early viral suppression improves neurocognitive outcomes in HIV-infected children. AIDS 2015;29:295.Google Scholar
  4. Elliot-DeSorbo DK, Martin S, Wolters PL. Stressful life events and their relationship to psychological and medical functioning in children and adolescents with HIV infection. J Acquir Immune Defic Syndr. 2009;52:364.CrossRefGoogle Scholar
  5. Epstein LG, Sharer LR, Joshi VV, Fojas MM, Koenigsberger MR, Oleske JM. Progressive encephalopathy in children with acquired immune deficiency syndrome. Ann Neurol. 1985;17:488–96.CrossRefPubMedGoogle Scholar
  6. Hurt H, Malmud E, Betancourt L, Braitman LE, Brodsky NL. Children with in utero cocaine exposure do not differ from control studies on intelligence testing. Arch Pediatr Adolesc Med. 1997;151:1237–41.CrossRefPubMedGoogle Scholar
  7. Kapetanovic S, Leister E, Nichols S, Miller T, Tassiopoulos K et al. … & Pediatric HIV/AIDS Cohort Study Team. Relationships between markers of vascular dysfunction and neurodevelopmental outcomes in perinatally HIV-infected youth. AIDS 2010;24:1481.Google Scholar
  8. Laughton B, Cornell M, Grove D, Kidd M, Springer PE, Dobbels E, Janse Van Rensburg A, Violari A, Babiker AG, Madhi SA, Jean-Philippe P, Gibb DM, Cotton MF. Early antiretroviral therapy improves neurodevelopmental outcomes in infants. AIDS 2012;26(13):1685–1690.Google Scholar
  9. Lazarus JR, Rutstein RM, Lowenthal ED. Treatment initiation factors and cognitive outcome in youth with perinatally acquired infection. HIV Med. 2015;16:355–61.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Mellins CA, Malee KM. Understanding the mental health of youth living with perinatal HIV infection: lessons learned and current challenges. J Int AIDS Soc. 2013;16:1–19.CrossRefGoogle Scholar
  11. Mellins CA, Tassiopoulos K, Malee K, Moscicki AB, Patton D, Pediatric HIV-AIDS Cohort Study, et al. Behavioral health risks in perinatally HIV-exposed youth: co-occurrence of sexual and drug use behavior, mental health problems, and nonadherence to antiretroviral treatment. AIDS Patient Care STDs. 2011;25:413–22.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Nachman SA, Chernoff M, Gona P, Van Dyke RB, Danker WM, Seage GR, Oleske J, Williams PL, PACTG p219 Team. Incidence of noninfectious conditions in perinatally HIV-infected children and adolescents in the HAART era. Arch Pediatr Adolesc Med. 2009;163:164–71.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Patel K, Ming X, Williams PL, Robertson KR, Oleske JM, Seage III GR, International Maternal Pediatric Adolescent AIDS Clinical Trials 219/219C Study Team. Impact of HAART and CNS-penetrating antiretroviral regimens on HIV encephalopathy among perinatally infected children and adolescents. AIDS. 2009;23:1893–901.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Peluso MJ, Valcour V, Ananworanich J, Sithinamsuwan P, Chalermchai T, et al. Absence of cerebrospinal fluid signs of neuronal injury before and after immediate antiretroviral therapy in acute HIV infection. J Infect Dis. 2015;212(11):1759–67. jiv296.CrossRefPubMedGoogle Scholar
  15. Pizzo PA, Eddy J, Falloon J, Balis FM, Murphy RF, et al. Effect of continuous intravenous infusion of zidovudine (AZT) in children with symptomatic HIV infection. N Engl J Med. 1988;319:889–96.CrossRefPubMedGoogle Scholar
  16. Puthanakit T, Ananworanich J, Vonthanak S, Kosalaraksa P, Hansudewechakul R, … and PREDICT Study Group. Cognitive function and neurodevelopmental outcomes in HIV-infected children older than 1 year of age randomized to early versus deferred antiretroviral therapy: the PREDICT neurodevelopmental study. Pediatr Infect Dis J. 2013;32:501.Google Scholar
  17. Shanbhag MC, Rutstein RM, Zaoutis T, Zhao H, Chao D, Radcliffe J. Neurocognitive functioning in pediatric human immunodeficiency virus infection: effects of combined therapy. Arch Pediatr Adolesc Med. 2005;159:651–6.CrossRefPubMedGoogle Scholar
  18. Smith R, Wilkins M. Perinatally acquired HIV infection: long-term neuropsychological consequences and challenges ahead. Child Neuropsychol. 2015;21:234–68.CrossRefPubMedGoogle Scholar
  19. Tassiopoulos K, Moscicki AB, Mellins C, Kacanek D, Malee K, et al. Sexual risk behavior among youth with perinatal HIV infection in the United States: predictors and implications for intervention development. Clin Infect Dis. 2013;56:283–90.CrossRefPubMedGoogle Scholar
  20. Wood SM, Shah SS, Steenhoff AP, Rutstein RM. The impact of AIDS diagnoses on long-term neurocognitive and psychiatric outcomes of surviving adolescents with perinatally acquired HIV. AIDS. 2009;23:1859–65.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Division of General PediatricsChildren’s Hospital of PhiladelphiaPhiladelphiaUSA
  2. 2.Department of PediatricsUniversity of Illinois at ChicagoChicagoUSA