Jillian Neary, Daisy Chebet, Sarah Benki-Nugent, Hellen Moraa, Barbra A Richardson, Irene Njuguna, Agnes Langat, Evelyn Ngugi, Dara A Lehman, Jennifer Slyker, Dalton Wamalwa, Grace John-Stewart
{"title":"Association between HIV and cytomegalovirus and neurocognitive outcomes among children with HIV.","authors":"Jillian Neary, Daisy Chebet, Sarah Benki-Nugent, Hellen Moraa, Barbra A Richardson, Irene Njuguna, Agnes Langat, Evelyn Ngugi, Dara A Lehman, Jennifer Slyker, Dalton Wamalwa, Grace John-Stewart","doi":"10.1097/QAD.0000000000004000","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Children with HIV may experience adverse neurocognitive outcomes despite antiretroviral therapy (ART). Cytomegalovirus (CMV) is common in children with HIV. Among children on ART, we examined the influences of early HIV viral load and CMV DNA on neurocognition.</p><p><strong>Design: </strong>We determined the association between pre-ART viral load, cumulative viral load, and CMV viremia and neurocognition using data from a cohort study.</p><p><strong>Methods: </strong>Children who initiated ART before 12 months of age were enrolled from 2007 to 2010 in Nairobi, Kenya. Blood was collected at enrollment and every 6 months thereafter. Four neurocognitive assessments with 12 domains were conducted when children were a median age of 7 years. Primary outcomes included cognitive ability, executive function, attention, and motor z scores. Generalized linear models were used to determine associations between HIV viral load (pre-ART and cumulative; N = 38) and peak CMV DNA (by 24 months of age; N = 20) and neurocognitive outcomes.</p><p><strong>Results: </strong>In adjusted models, higher peak CMV viremia by 24 months of age was associated with lower cognitive ability and motor z scores. Higher pre-ART HIV viral load was associated with lower executive function z scores. Among secondary outcomes, higher pre-ART viral load was associated with lower mean nonverbal and metacognition z scores.</p><p><strong>Conclusion: </strong>Higher pre-ART viral load and CMV DNA in infancy were associated with lower executive function, nonverbal and metacognition scores and cognitive ability and motor scores in childhood, respectively. These findings suggest long-term benefits of early HIV viral suppression and CMV control on neurocognition.</p>","PeriodicalId":7502,"journal":{"name":"AIDS","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11524778/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"AIDS","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/QAD.0000000000004000","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/28 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Children with HIV may experience adverse neurocognitive outcomes despite antiretroviral therapy (ART). Cytomegalovirus (CMV) is common in children with HIV. Among children on ART, we examined the influences of early HIV viral load and CMV DNA on neurocognition.
Design: We determined the association between pre-ART viral load, cumulative viral load, and CMV viremia and neurocognition using data from a cohort study.
Methods: Children who initiated ART before 12 months of age were enrolled from 2007 to 2010 in Nairobi, Kenya. Blood was collected at enrollment and every 6 months thereafter. Four neurocognitive assessments with 12 domains were conducted when children were a median age of 7 years. Primary outcomes included cognitive ability, executive function, attention, and motor z scores. Generalized linear models were used to determine associations between HIV viral load (pre-ART and cumulative; N = 38) and peak CMV DNA (by 24 months of age; N = 20) and neurocognitive outcomes.
Results: In adjusted models, higher peak CMV viremia by 24 months of age was associated with lower cognitive ability and motor z scores. Higher pre-ART HIV viral load was associated with lower executive function z scores. Among secondary outcomes, higher pre-ART viral load was associated with lower mean nonverbal and metacognition z scores.
Conclusion: Higher pre-ART viral load and CMV DNA in infancy were associated with lower executive function, nonverbal and metacognition scores and cognitive ability and motor scores in childhood, respectively. These findings suggest long-term benefits of early HIV viral suppression and CMV control on neurocognition.
期刊介绍:
Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.