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临床稳定的HIV感染儿童的行为和认知概况。

A behavioral and cognitive profile of clinically stable HIV-infected children.

作者信息

Nozyce Molly L, Lee Sophia S, Wiznia Andrew, Nachman Sharon, Mofenson Lynne M, Smith Mary E, Yogev Ram, McIntosh Kenneth, Stanley Kenneth, Pelton Stephen

机构信息

Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, New York, USA.

出版信息

Pediatrics. 2006 Mar;117(3):763-70. doi: 10.1542/peds.2005-0451.

Abstract

OBJECTIVE

The purpose of this research was to characterize behavioral and cognitive profiles of clinically and immunologically stable antiretroviral-experienced HIV-infected children.

METHODS

Two hundred seventy-four previously treated HIV-infected children aged 2 to 17 years were assessed for behavioral, developmental, and cognitive functioning. Correlations between neuropsychological measures, age, and CD4 lymphocyte count were investigated.

RESULTS

The most common behavioral problems, as measured by the Conners' Parent Rating Scale, were psychosomatic (28%), learning (25%), hyperactivity (20%), impulsive-hyperactive (19%), conduct (16%), and anxiety (8%) problems. Mean Wechsler Intelligence Scale for Children-III scores were less than established population norms; the mean verbal IQ was 85, the mean performance IQ was 90, and the mean full-scale score was 86. Hyperactivity was more frequent in children with a Wechsler Intelligence Scale for Children-III performance IQ of <90. Anxiety problems were more likely in children > or =9 years of age. Children with CD4 counts of <660 cells per mm3 were more likely to be identified as having a conduct disorder. No association was noted between behavioral problems and neuroimaging.

CONCLUSIONS

Clinically and immunologically stable HIV-infected children had more frequent behavioral problems and lower developmental and cognitive scores than established childhood norms.

摘要

目的

本研究旨在描述临床上和免疫上稳定的、有抗逆转录病毒治疗经验的HIV感染儿童的行为和认知特征。

方法

对274名年龄在2至17岁、曾接受过治疗的HIV感染儿童进行行为、发育和认知功能评估。研究神经心理测量、年龄和CD4淋巴细胞计数之间的相关性。

结果

根据康纳斯父母评定量表测量,最常见的行为问题是身心问题(28%)、学习问题(25%)、多动问题(20%)、冲动多动问题(19%)、品行问题(16%)和焦虑问题(8%)。韦氏儿童智力量表第三版的平均得分低于既定的人群常模;平均言语智商为85,平均操作智商为90,平均全量表得分是86。在韦氏儿童智力量表第三版操作智商<90的儿童中,多动问题更为常见。9岁及以上儿童更易出现焦虑问题。CD4计数<660个细胞/mm³的儿童更有可能被认定患有品行障碍。未发现行为问题与神经影像学之间存在关联。

结论

临床上和免疫上稳定的HIV感染儿童比既定的儿童常模有更频繁的行为问题以及更低的发育和认知得分。

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