RT Journal Article
SR Electronic
T1 Neurodevelopment of HIV-Exposed and HIV-Unexposed Uninfected Children at 24 Months
JF Pediatrics
JO Pediatrics
FD American Academy of Pediatrics
SP e20170988
DO 10.1542/peds.2017-0988
VO 140
IS 4
A1 Chaudhury, Sumona
A1 Williams, Paige L.
A1 Mayondi, Gloria K.
A1 Leidner, Jean
A1 Holding, Penny
A1 Tepper, Vicki
A1 Nichols, Sharon
A1 Magetse, Jane
A1 Sakoi, Maureen
A1 Moabi, Kebaiphe
A1 Makhema, Joseph
A1 Mdluli, Charlotte
A1 Jibril, Haruna
A1 Seage, George R.
A1 Kammerer, Betsy
A1 Lockman, Shahin
YR 2017
UL http://pediatrics.aappublications.org/content/140/4/e20170988.abstract
AB BACKGROUND: We sought to determine if HIV-exposed uninfected (HEU) children had worse neurodevelopmental outcomes at 24 months compared with HIV-unexposed uninfected (HUU) children in Botswana.METHODS: HIV-infected and uninfected mothers enrolled in a prospective observational study (“Tshipidi”) in Botswana from May 2010 to July 2012. Child neurodevelopment was assessed at 24 months with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III: cognitive, gross motor, fine motor, expressive language, and receptive language domains) and the Development Milestones Checklist (DMC), a caregiver-completed questionnaire (locomotor, fine motor, language and personal-social domains). We used linear regression models to estimate the association of in-utero HIV exposure with neurodevelopment, adjusting for socioeconomic and maternal health characteristics.RESULTS: We evaluated 670 children (313 HEU, 357 HUU) with ≥1 valid Bayley-III domain assessed and 723 children (337 HEU, 386 HUU) with a DMC. Among the 337 HEU children with either assessment, 122 (36%) were exposed in utero to maternal 3-drug antiretroviral treatment and 214 (64%) to zidovudine. Almost all HUU children (99.5%) breastfed, compared with only 9% of HEU children. No domain score was significantly lower among HEU children in adjusted analyses. Bayley-III cognitive and DMC personal-social domain scores were significantly higher in HEU children than in HUU children, but differences were small.CONCLUSIONS: HEU children performed equally well on neurodevelopmental assessments at 24 months of age compared with HUU children. Given the global expansion of the HEU population, results suggesting no adverse impact of in-utero HIV and antiretroviral exposure on early neurodevelopment are reassuring.