Subcortical Brain Volumes and Neurocognitive Function in Children With Perinatal HIV Exposure: A Population-Based Cohort Study in South Africa.

Autor: Wedderburn CJ; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa., Yeung S; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom., Groenewold NA; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa., Rehman AM; Medical Research Council Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom., Subramoney S; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Fouche JP; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa., Joshi SH; Department of Neurology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA.; Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA., Narr KL; Department of Neurology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA., Hoffman N; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa., Roos A; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa., Gibb DM; Medical Research Council Clinical Trials Unit, University College London, London, United Kingdom., Zar HJ; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa., Stein DJ; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.; South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa., Donald KA; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Jazyk: angličtina
Zdroj: Open forum infectious diseases [Open Forum Infect Dis] 2024 Jul 17; Vol. 11 (7), pp. ofae317. Date of Electronic Publication: 2024 Jul 17 (Print Publication: 2024).
DOI: 10.1093/ofid/ofae317
Abstrakt: Background: Children who are HIV-exposed and uninfected (HEU) are at risk for early neurodevelopmental impairment. Smaller basal ganglia nuclei have been reported in neonates who are HEU compared to HIV-unexposed (HU); however, neuroimaging studies outside infancy are scarce. We examined subcortical brain structures and associations with neurocognition in children who are HEU.
Methods: This neuroimaging study was nested within the Drakenstein Child Health Study birth cohort in South Africa. We compared (T1-weighted) magnetic resonance imaging-derived subcortical brain volumes between children who were HEU (n = 70) and HU (n = 92) at age 2-3 years using linear regression. Brain volumes were correlated with neurodevelopmental outcomes measured with the Bayley Scales of Infant and Toddler Development III.
Results: Compared to HU children, on average children who were HEU had 3% lower subcortical grey matter volumes. Analyses of individual structures found smaller volume of the putamen nucleus in the basal ganglia (-5% difference, P = .016) and the hippocampus (-3% difference, P = .044), which held on adjustment for potential confounders ( P < .05). Maternal viremia and lower CD4 count in pregnancy were associated with smaller child putamen volumes. Children who were HEU had lower language scores than HU; putamen and hippocampus volumes were positively correlated with language outcomes.
Conclusions: Overall, children who are HEU had a pattern of smaller subcortical volumes in the basal ganglia and hippocampal regions compared to HU children, which correlated with language function. Findings suggest that optimizing maternal perinatal HIV care is important for child brain development. Further studies are needed to investigate underlying mechanisms and long-term outcomes.
Competing Interests: Potential conflicts of interest. D. J. S. has received research grants and/or consultancy honoraria from Discovery Vitality, Johnson & Johnson, Kanna, L’Oreal, Lundbeck, Orion, Sanofi, Servier, Takeda, and Vistagen. All other authors report no potential conflicts.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.)
Databáze: MEDLINE
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