Cognitive impairment persists in children and adolescents living with HIV even in the era of antiretroviral therapy (ART), according to research published online April 23 in eClinicalMedicine.
Sophia Dahmani, from Georgetown University Medical Center in Washington, D.C., and colleagues conducted a meta-analysis to evaluate the impact of perinatal HIV infection on executive function, working memory, and speed of information processing in the ART era. The analysis included data from 35 studies (2012 to 2023) that included 4,066 perinatally infected HIV patients, 2,349 HIV-exposed uninfected (HEU) controls, and 2,466 HIV-unexposed, uninfected (HUU) controls.
The researchers found that compared with HEU and HUU controls, perinatally HIV-infected children and adolescents presented with significant impairments in processing speed, working memory, and to a lesser degree, executive function. There was a negative correlation observed between the effect estimate of processing speed impairment and gross national income per capita of the study countries, even though HIV-infected cases were compared to sociodemographically matched HUU controls from the same countries. The performance gap between HIV-infected cases and HUU/HEU controls may be larger in low-/middle-income countries compared with high-income countries.
“The introduction of early childhood education programs, academic accommodations whereby teachers provide more time during exams to account for reduced processing speeds, and caregiver training programs could help improve the long-term cognitive and functional outcomes of these children and adolescents,” senior author Xiong Jiang, Ph.D., also from Georgetown, said in a statement.
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