Increased Risk of Executive Function and Emotional Behavioral Problems Among Virologically Well-Controlled Perinatally HIV-Infected Adolescents in Thailand and Cambodia.

Autor:	Kerr SJ; The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.; Biostatistics Excellence Centre, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.; The Kirby Institute, The University of New South Wales, Sydney, Australia., Puthanakit T; The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.; Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand., Malee KM; Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL., Thongpibul K; Department of Psychology, Faculty of Humanities, Chiang Mai University, Chiang Mai, Thailand., Ly PS; National Center for HIV/AIDS Dermatology and STDs, Phnom Penh, Cambodia., Sophonphan J; The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand., Suwanlerk T; The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), The Thai Red Cross AIDS Research Centre, Bangkok, Thailand., Kosalaraksa P; Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand., Ounchanum P; Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand., Aurpibul L; Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand., Kanjanavanit S; Nakornping Hospital, Chiang Mai, Thailand., Ngampiyaskul C; Prapokklao Hospital, Chanthaburi, Thailand., Chettra K; National Center for HIV/AIDS Dermatology and STDs, Phnom Penh, Cambodia., Robbins R; HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York, NY., Paul R; Missouri Institute of Mental Health, University of Missouri-St. Louis, St. Louis, MO., Ananworanich J; SEARCH, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD.; U.S. Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, MD.; Department of Global Health, University of Amsterdam, Amsterdam, the Netherlands., Mellins CA; HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York, NY.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2019 Nov 01; Vol. 82 (3), pp. 297-304.
DOI:	10.1097/QAI.0000000000002132
Abstrakt:	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.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu