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The timing of mother-to-child transmission of human immunodeficiency virus infection and the neurodevelopment of children in Tanzania

The timing of mother-to-child transmission of human immunodeficiency virus infection and the neurodevelopment of children in Tanzania
The timing of mother-to-child transmission of human immunodeficiency virus infection and the neurodevelopment of children in Tanzania
OBJECTIVE: To determine the association between the timing of mother-to-child transmission of human immunodeficiency virus (HIV)-1 and neurodevelopment among children born to HIV-1 infected mothers in Tanzania.

METHODS: Bayley Scales of Infant Development (2nd edition) were administered at 6, 12 and 18 months to a subset of children (N = 327). Linear regression models and Cox proportional hazard models were separately fitted for the mental development index (MDI) and the psychomotor development index (PDI).

RESULTS: Children who tested HIV-1-positive at birth had significantly higher decreases per month in MDI and PDI than HIV-1-negative children; 1.1 [95% confidence interval (95% CI), 0.4, 1.8] for MDI and 1.4 (95% CI 0.0, 2.7] for PDI. Children who tested HIV-1-positive after birth had an additional 0.6 (95% CI 0.1, 1.1) point decrease in MDI per month and a 0.6 (95% CI 0.0, 1.1) higher decrease in PDI each month than HIV-1-negative children. Testing HIV-1-positive at birth was associated with a 14.9 (95% CI 5.0, 44.7) times higher rate of becoming developmentally delayed in mental function, while testing HIV-1-positive after birth was associated with a 3.2 (95% CI 1.6, 6.4) times higher rate than in uninfected children.

CONCLUSIONS: HIV-1 infected infants performed worse on tests of neurodevelopment and were significantly more likely to be identified as developmentally delayed in the first 18 months of life than HIV-1-negative children. The effect of HIV-1 infection on neurodevelopment scores and the risk of developmental delay may be highest among those who are already HIV-1 infected at birth.
47-52
McGrath, N.
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Fawzi, W.W.
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Bellinger, D.
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Robins, J.
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Msamanga, G.I.
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Manji, K.
6086e745-8c61-43bf-bb1c-af401566bef7
Tronick, E.
c152a8cf-1122-403d-b066-11b4ee923d9e
McGrath, N.
b75c0232-24ec-443f-93a9-69e9e12dc961
Fawzi, W.W.
57972fc9-8504-42a1-9f9f-094942d11898
Bellinger, D.
4a918ef0-90db-4265-9999-e66a7236223d
Robins, J.
0906d29d-f46f-4d69-b134-f24e55c49997
Msamanga, G.I.
d7825a8c-3340-40e5-aea5-a45dc8acb7ca
Manji, K.
6086e745-8c61-43bf-bb1c-af401566bef7
Tronick, E.
c152a8cf-1122-403d-b066-11b4ee923d9e

McGrath, N., Fawzi, W.W., Bellinger, D., Robins, J., Msamanga, G.I., Manji, K. and Tronick, E. (2006) The timing of mother-to-child transmission of human immunodeficiency virus infection and the neurodevelopment of children in Tanzania. Pediatric Infectious Disease Journal, 25 (1), 47-52. (PMID:16395103)

Record type: Article

Abstract

OBJECTIVE: To determine the association between the timing of mother-to-child transmission of human immunodeficiency virus (HIV)-1 and neurodevelopment among children born to HIV-1 infected mothers in Tanzania.

METHODS: Bayley Scales of Infant Development (2nd edition) were administered at 6, 12 and 18 months to a subset of children (N = 327). Linear regression models and Cox proportional hazard models were separately fitted for the mental development index (MDI) and the psychomotor development index (PDI).

RESULTS: Children who tested HIV-1-positive at birth had significantly higher decreases per month in MDI and PDI than HIV-1-negative children; 1.1 [95% confidence interval (95% CI), 0.4, 1.8] for MDI and 1.4 (95% CI 0.0, 2.7] for PDI. Children who tested HIV-1-positive after birth had an additional 0.6 (95% CI 0.1, 1.1) point decrease in MDI per month and a 0.6 (95% CI 0.0, 1.1) higher decrease in PDI each month than HIV-1-negative children. Testing HIV-1-positive at birth was associated with a 14.9 (95% CI 5.0, 44.7) times higher rate of becoming developmentally delayed in mental function, while testing HIV-1-positive after birth was associated with a 3.2 (95% CI 1.6, 6.4) times higher rate than in uninfected children.

CONCLUSIONS: HIV-1 infected infants performed worse on tests of neurodevelopment and were significantly more likely to be identified as developmentally delayed in the first 18 months of life than HIV-1-negative children. The effect of HIV-1 infection on neurodevelopment scores and the risk of developmental delay may be highest among those who are already HIV-1 infected at birth.

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e-pub ahead of print date: January 2006
Organisations: Primary Care & Population Sciences, Faculty of Social, Human and Mathematical Sciences

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Local EPrints ID: 350532
URI: http://eprints.soton.ac.uk/id/eprint/350532
PURE UUID: 6dd0be8a-a665-44f3-93e1-54a4c75321cd
ORCID for N. McGrath: ORCID iD orcid.org/0000-0002-1039-0159

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Date deposited: 26 Mar 2013 12:26
Last modified: 03 Dec 2019 01:36

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