Mellins Claude A, Smith Renee, O'Driscoll Peter, Magder Lawrence S, Brouwers Pim, Chase Cynthia, Blasini Ileana, Hittleman Joan, Llorente Antolin, Matzen Elaine
Columbia College of Physicians and Surgeons, New York, New York, USA.
Pediatrics. 2003 Feb;111(2):384-93. doi: 10.1542/peds.111.2.384.
Descriptive studies and clinical reports have suggested that human immunodeficiency virus (HIV)-positive children are at risk for behavioral problems. Inadequate control groups and sample sizes have limited the ability of investigators to consider multiple influences that place HIV-positive children at risk for poor behavioral outcomes. We examined the unique and combined influences of HIV, prenatal drug exposure, and environmental factors on behavior in children who were perinatally exposed to HIV.
Participants included 307 children who were born to HIV-positive mothers (96 HIV infected and 211 seroreverters) and enrolled in a natural history, longitudinal study of women to infant HIV transmission. Caregivers completed parent behavioral rating scales, beginning when the children were 3 years old. Data were also collected on prenatal drug exposure; child age, gender, and ethnicity; caregiver relationship to child; and birth complications.
Multivariate analyses comparing the HIV-infected children with perinatally exposed but uninfected children from similar backgrounds failed to find an association between either HIV status or prenatal drug exposure and poor behavioral outcomes. The strongest correlates of increased behavioral symptoms were demographic characteristics.
This study suggests that although a high prevalence of behavioral problems does exist among HIV-infected children, neither HIV infection nor prenatal drug exposure is the underlying cause. Rather, other biological and environmental factors are likely contributors toward poor behavioral outcomes.
描述性研究和临床报告表明，感染人类免疫缺陷病毒（HIV）的儿童存在行为问题风险。对照组不充分以及样本量有限，限制了研究人员考量多种使HIV阳性儿童面临行为不良后果风险的影响因素的能力。我们研究了HIV、产前药物暴露和环境因素对围生期暴露于HIV的儿童行为的独特及综合影响。
参与者包括307名HIV阳性母亲所生的儿童（96名HIV感染者和211名血清转化者），这些儿童参与了一项关于母婴HIV传播的自然史纵向研究。从孩子3岁起，照料者完成父母行为评定量表。还收集了有关产前药物暴露、儿童年龄、性别和种族、照料者与儿童的关系以及出生并发症的数据。
多变量分析将感染HIV的儿童与背景相似的围生期暴露但未感染的儿童进行比较，未发现HIV感染状况或产前药物暴露与行为不良后果之间存在关联。行为症状增加的最强烈相关因素是人口统计学特征。
这项研究表明，尽管感染HIV的儿童中确实存在行为问题的高患病率，但HIV感染和产前药物暴露都不是根本原因。相反，其他生物和环境因素可能是导致行为不良后果的原因。
