Koekkoek Sanneke, de Sonneville Leo M J, Wolfs Tom F W, Licht Rob, Geelen Sibyl P M
Department of Clinical Neuropsychology, Faculty of Psychology and Education, Vrije Universiteit, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands.
Eur J Paediatr Neurol. 2008 Jul;12(4):290-7. doi: 10.1016/j.ejpn.2007.09.002. Epub 2007 Oct 18.
Evaluation of neurocognitive function of school-age children with HIV.
Cross-sectional observational study.
Twenty-two children (median age 9.46 years) with perinatally acquired HIV infection were administered a global intelligence test and tests from the Amsterdam Neuropsychological Tasks (ANT) program. The relationship between various patient-, disease- and treatment factors and neurocognitive outcome variables was examined.
Compared with age-appropriate norms, mean IQ of the HIV-infected children was in the average range. However, the HIV-infected children performed poorer on several neuropsychological tests compared with age-appropriate norms. Executive function (attentional flexibility, visuospatial working memory) and processing speed emerged as the most sensitive cognitive measures in relation to HIV disease. The correlational analyses resulted in only two significant outcomes, showing that higher CD4% at initiation of highly active antiretroviral therapy (HAART) and longer treatment duration were associated with better working memory function and attentional control, respectively.
These exploratory data suggest that subtle neurocognitive impairments may exist in HIV-infected school-age children, in particular characterized by compromised executive function and slowed information processing. Further research with larger sample sizes is needed to confirm these findings.
评估感染人类免疫缺陷病毒(HIV)的学龄儿童的神经认知功能。
横断面观察性研究。
对22名围产期感染HIV的儿童(中位年龄9.46岁)进行了一项综合智力测试以及阿姆斯特丹神经心理学任务(ANT)项目中的测试。研究了各种患者因素、疾病因素和治疗因素与神经认知结果变量之间的关系。
与适龄儿童的正常水平相比,感染HIV的儿童的平均智商处于平均范围。然而,与适龄儿童的正常水平相比,感染HIV的儿童在多项神经心理学测试中的表现较差。执行功能(注意力灵活性、视觉空间工作记忆)和处理速度是与HIV疾病相关的最敏感的认知指标。相关性分析仅得出两个显著结果,表明在开始高效抗逆转录病毒治疗(HAART)时较高的CD4%和较长的治疗持续时间分别与更好的工作记忆功能和注意力控制相关。
这些探索性数据表明,感染HIV的学龄儿童可能存在细微的神经认知障碍,尤其表现为执行功能受损和信息处理速度减慢。需要进行更大样本量的进一步研究来证实这些发现。