Impact of HIV severity on cognitive and adaptive functioning during childhood and adolescence.

摘要: As the majority of youth with perinatally acquired HIV infection (PHIV+) are aging into adolescence and young adulthood, it is important to understand long-term impact concomitant risk factors on cognitive abilities adaptive functioning these youth. Knowledge individual strengths vulnerabilities critical for understanding quality life health issues, including current future educational needs, appropriate career options, adherence, high-risk behaviors, likelihood functional independence during adulthood. Previous studies PHIV+ children described global specific effects central nervous system (CNS) functioning, ranging in severity from pervasive subtle, most severe form being encephalopathy. With advent highly active antiretroviral therapy (HAART), incidence CNS impairment has decreased significantly,1-3 yet only recently neurocognitive profiles HAART-experienced, older emerging. These suggest overall low average range deficits areas such as working memory executive functioning.3-8 Results few ability function effectively within school other social settings.9-12 Biomedical markers virologic immunologic status CD4+ T-lymphocyte count percentage, CDC classification disease13, exposure HAART, timing transmission, RNA viral load (VL) key predictors assessing impairment, even children5,8,11,12,14-18. In particular, that an early AIDS-defining illness or nadir CD4 associated HIV+ youth.6,8,11,18 However, earlier linking disease neurobehavioral school-aged were limited by small sample sizes, absent inadequate comparison groups, thus inability evaluate potential confounding demographic psychosocial may negatively affect outcome The aim this study was examine a large group cohort who HIV-exposed but uninfected (PHEU) share similar characteristics. We hypothesized prior AIDS diagnosis (i.e. Class C) would have greatest while without C diagnoses PHEU backgrounds. also aimed identify biological, demographic, poor functioning.