Sirois Patricia A, Chernoff Miriam C, Malee Kathleen M, Garvie Patricia A, Harris Lynnette L, Williams Paige L, Woods Steven P, Nozyce Molly L, Kammerer Betsy L, Yildirim Cenk, Nichols Sharon L
Department of Pediatrics, Tulane University School of Medicine, New Orleans, Louisiana.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts.
J Pediatric Infect Dis Soc. 2016 Dec;5(suppl 1):S24-S32. doi: 10.1093/jpids/piw046.
Perinatally acquired HIV (PHIV) confers risk for neurocognitive impairment, which potentially affects school performance and functional independence of infected children. In this study, we examined the associations of 2 key neurocognitive domains, memory and executive function (EF), with academic and adaptive skills among youth with PHIV and perinatally HIV-exposed but uninfected (PHEU) youth.
Participants ages 9 to <19 years enrolled in the Pediatric HIV/AIDS Cohort Study's Memory and Executive Functioning Study completed standardized measures of reading and math. The primary caregivers completed a standardized measure of their child's adaptive behavior. Participants with PHIV, those with (PHIV/C) and without (PHIV/non-C) a Centers for Disease Control and Prevention class C diagnosis, and PHEU participants were compared. Retrospective memory (RM), prospective memory (PM), and EF were evaluated relative to outcomes using general linear regression models adjusted for sociodemographic characteristics.
Of the participants (N = 258; mean age, 14.1 years), 46% were male, 75% were black, and 18% were Hispanic. Adjusted mean scores in math and adaptive behavior did not differ among the youth with PHIV/C (n = 45), those with PHIV/non-C (n = 128), and PHEU youth (n = 85). Youth with PHIV/C had lower adjusted mean reading scores than PHIV/non-C and PHEU youth (86.9 vs 93.8 [P = .02] and 93.2 [P = .04], respectively). There were positive associations of RM, PM, EF, and some sociodemographic characteristics with higher reading and math scores. Immediate and delayed verbal memory, delayed visual memory, PM, and some EF measures were positively associated with adaptive behavior.
Higher-order cognitive abilities such as memory and EF seem to play a key role in academic and adaptive capacities, regardless of a child's HIV status, and might serve as intervention targets for improving functional outcomes.
围生期获得性HIV（PHIV）会导致神经认知障碍风险，这可能会影响受感染儿童的学业成绩和功能独立性。在本研究中，我们调查了记忆和执行功能（EF）这两个关键神经认知领域与PHIV青少年以及围生期暴露于HIV但未感染（PHEU）的青少年的学业和适应技能之间的关联。
参加儿科HIV/艾滋病队列研究的记忆与执行功能研究的9至<19岁参与者完成了阅读和数学的标准化测量。主要照顾者完成了对其孩子适应性行为的标准化测量。对患有PHIV的参与者、患有（PHIV/C）和未患有（PHIV/非C）疾病控制与预防中心C类诊断的参与者以及PHEU参与者进行了比较。使用针对社会人口学特征进行调整的一般线性回归模型，相对于结局评估了回顾性记忆（RM）、前瞻性记忆（PM）和EF。
在参与者（N = 258；平均年龄14.1岁）中，46%为男性，75%为黑人，18%为西班牙裔。患有PHIV/C（n = 45）、患有PHIV/非C（n = 128）的青少年和PHEU青少年（n = 85）在数学和适应性行为方面的调整后平均得分没有差异。患有PHIV/C的青少年的调整后平均阅读得分低于PHIV/非C和PHEU青少年（分别为86.9对93.8 [P = .02]和93.2 [P = .04]）。RM、PM、EF和一些社会人口学特征与较高的阅读和数学得分呈正相关。即时和延迟言语记忆、延迟视觉记忆、PM和一些EF测量与适应性行为呈正相关。
记忆和EF等高阶认知能力似乎在学业和适应能力中起关键作用，无论儿童的HIV状态如何，并且可能作为改善功能结局的干预目标。
