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Predicting HIV disease progression in children using measures of neuropsychological and neurological functioning

Predicting HIV disease progression in children using measures of neuropsychological and neurological functioning
Predicting HIV disease progression in children using measures of neuropsychological and neurological functioning
Background: Neuropsychological testing and 2 measures of neurological status, cortical atrophy, and motor dysfunction were assessed for their usefulness in predicting human immunodeficiency virus (HIV) disease progression in infants, children, and adolescents who participated in Pediatric AIDS Clinical Trials Group Protocol 152 (PACTG 152).

Methods: A cohort of 722 antiretroviral therapy-naive children with symptomatic HIV infection were assessed at study entry and at later intervals. Assessments included neurodevelopmental testing, neuroradiologic imaging, and neurological examination of motor function. CD4 cell count and plasma RNA viral load also were measured.

Results: Children with the lowest neuropsychological functioning (IQ < 70) at baseline had the highest risk for later HIV disease progression (56%), compared with those with borderline/low (IQ = 70–89) functioning (26%), or with average or above (IQ > 90) functioning (18%). This was also true of week 48 neuropsychological functioning. Motor dysfunction (especially reduced muscle mass) at entry also predicted disease progression. Furthermore, motor dysfunction and week 48 neuropsychological functioning provided predictive information beyond that obtainable from surrogate markers of HIV disease status (eg, CD4 count, HIV RNA level). Children with cortical atrophy also were at higher risk for later disease progression, but when CD4 count and RNA viral load were known, cortical atrophy information provided no additional predictive information.

Conclusions: Measures of neuropsychological and motor function status provide unique information regarding pediatric HIV disease progression. As such, these findings have important implications for predicting long-term outcomes (eg, longevity) in pediatric patients.
0031-4005
e76
Pearson, D.
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McGrath, N.
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Nozyce, M.
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Nichols, S.
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Raskino, C.
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Brouwers, P.
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Lifschitz, M.
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Baker, C.
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Englund, J.
aee5fa26-4e6d-4089-bc69-801ae53f178b
Pearson, D.
cdf01397-f4a5-4a97-bda1-0427bf81d730
McGrath, N.
b75c0232-24ec-443f-93a9-69e9e12dc961
Nozyce, M.
8f193b2b-09ca-4b02-b703-f2140445557d
Nichols, S.
c4b1ac60-29af-4057-b168-b494e80fdf4d
Raskino, C.
45f36799-1cfa-46da-a2dd-938630f8f013
Brouwers, P.
3c605044-15c1-43fa-abc8-f61620a2cd2c
Lifschitz, M.
1dc6cb93-bf04-4875-b814-a2175d88ce86
Baker, C.
04dda9b5-d169-4c54-a963-d97eae49da33
Englund, J.
aee5fa26-4e6d-4089-bc69-801ae53f178b

Pearson, D., McGrath, N., Nozyce, M., Nichols, S., Raskino, C., Brouwers, P., Lifschitz, M., Baker, C. and Englund, J. (2000) Predicting HIV disease progression in children using measures of neuropsychological and neurological functioning. Pediatrics, 106 (6), e76. (doi:10.1542/peds.106.6.e76). (PMID:11099619)

Record type: Article

Abstract

Background: Neuropsychological testing and 2 measures of neurological status, cortical atrophy, and motor dysfunction were assessed for their usefulness in predicting human immunodeficiency virus (HIV) disease progression in infants, children, and adolescents who participated in Pediatric AIDS Clinical Trials Group Protocol 152 (PACTG 152).

Methods: A cohort of 722 antiretroviral therapy-naive children with symptomatic HIV infection were assessed at study entry and at later intervals. Assessments included neurodevelopmental testing, neuroradiologic imaging, and neurological examination of motor function. CD4 cell count and plasma RNA viral load also were measured.

Results: Children with the lowest neuropsychological functioning (IQ < 70) at baseline had the highest risk for later HIV disease progression (56%), compared with those with borderline/low (IQ = 70–89) functioning (26%), or with average or above (IQ > 90) functioning (18%). This was also true of week 48 neuropsychological functioning. Motor dysfunction (especially reduced muscle mass) at entry also predicted disease progression. Furthermore, motor dysfunction and week 48 neuropsychological functioning provided predictive information beyond that obtainable from surrogate markers of HIV disease status (eg, CD4 count, HIV RNA level). Children with cortical atrophy also were at higher risk for later disease progression, but when CD4 count and RNA viral load were known, cortical atrophy information provided no additional predictive information.

Conclusions: Measures of neuropsychological and motor function status provide unique information regarding pediatric HIV disease progression. As such, these findings have important implications for predicting long-term outcomes (eg, longevity) in pediatric patients.

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e-pub ahead of print date: December 2000
Organisations: Primary Care & Population Sciences, Faculty of Social, Human and Mathematical Sciences

Identifiers

Local EPrints ID: 350537
URI: http://eprints.soton.ac.uk/id/eprint/350537
ISSN: 0031-4005
PURE UUID: 0879f850-cc9f-4ae5-ab1a-283a593f10dd
ORCID for N. McGrath: ORCID iD orcid.org/0000-0002-1039-0159

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Date deposited: 26 Mar 2013 13:12
Last modified: 23 Jul 2022 02:07

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Contributors

Author: D. Pearson
Author: N. McGrath ORCID iD
Author: M. Nozyce
Author: S. Nichols
Author: C. Raskino
Author: P. Brouwers
Author: M. Lifschitz
Author: C. Baker
Author: J. Englund

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