Cognitive and language outcomes in HIV-uninfected infants exposed to combined antiretroviral therapy in utero and through extended breast-feeding.

Journal: AIDS (London, England)

Volume: 28 Suppl 3

Issue: 

Year of Publication: 2015

Affiliated Institutions:  aUniversity of Zambia School of Medicine bDepartment of Pediatrics, University Teaching Hospital, Lusaka, Zambia cUniversity of Toronto, Toronto dUniversity of British Columbia eWomen's Health Research Institute fCentre for Blood Research, Vancouver gThe Hospital for Sick Children, Toronto hPublic Health Agency of Canada, Ottawa iWestern University, London, Canada.

Abstract summary 

To determine whether there is a higher risk for cognitive or language delay among HIV-exposed uninfected (HEU) children exposed to cART (zidovudine/lamivudine/lopinavir/ritonavir) in utero and through 1 year of breast-feeding (World health Organization Option B+), compared with the control children born to HIV-uninfected mothers.This is a double cohort study from Lusaka, Zambia.HEU (n = 97) and control (n = 103) children aged 15-36 months were assessed on their early nonverbal problem-solving and language skills using the standardized Capute Scales. A score of less than 85 on the Capute Full-Scale Developmental Quotient (FSDQ) was considered indicative of developmental delay and was the primary outcome of interest.An FSDQ of less than 85 was found in eight (8.3%) of HEU participants and 15 (14.6%) of controls. In univariate logistic regressions, lower income [odds ratio (OR) = 0.93, P = 0.02], older infant age (OR = 1.08, P = 0.03), lower birth weight (OR = 0.16, P < 0.001), and less maternal education (OR = 0.41, P = 0.047) were associated with the probability of FSDQ less than 85, whereas Group (control/HEU) was not (OR = 1.88, P = 0.16). In the multivariable analysis, only lower birth weight (OR = 0.15, P < 0.001) remained associated with FSDQ less than 85.Our study did not support the presence of an adverse effect on cognitive and language development with prolonged antepartum and postpartum cART e/xposure. Larger studies and studies of older HEU children will be required to confirm these reassuring findings.

Authors & Co-authors:  Ngoma Mary S MS Hunter Jennifer A JA Harper Jessica A JA Church Paige T PT Mumba Scholastica S Chandwe Mulapati M Côté Hélène C F HC Albert Arianne Y K AY Smith Mary-Lou ML Selemani Chisomo C Sandstrom Paul A PA Bandenduck Lucas L Ndlovu Utsile U Khan Sara S Roa Lina L Silverman Michael S MS

Study Outcome 

Source Link: Visit source

Statistics
Citations : 
Authors :  16
Identifiers
Doi : 10.1097/QAD.0000000000000357
SSN : 1473-5571
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
Study Design
Cohort Study
Study Approach
Country of Study
Zambia
Publication Country
England