Malee Kathleen M, Chernoff Miriam C, Sirois Patricia A, Williams Paige L, Garvie Patricia A, Kammerer Betsy L, Harris Lynnette L, Nozyce Molly L, Yildirim Cenk, Nichols Sharon L
*Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL; †Center for Biostatistics in AIDS Research, Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA; ‡Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA; §Research Department, Children's Diagnostic and Treatment Center, Fort Lauderdale, FL; ‖Department of Psychiatry, Boston Children's Hospital, Boston, MA; ¶Department of Pediatrics, Baylor College of Medicine, Houston, TX; #Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY; and **Department of Neurosciences, University of California, San Diego, La Jolla, CA.
J Acquir Immune Defic Syndr. 2017 Aug 1;75(4):455-464. doi: 10.1097/QAI.0000000000001441.
Little is known regarding effects of perinatally acquired HIV infection (PHIV) on longitudinal change in memory and executive functioning (EF) during adolescence despite the importance of these skills for independence in adulthood.
PHIV (n = 144) and perinatally HIV-exposed uninfected youth (PHEU, n = 79), ages 12-17, completed standardized tests of memory and EF at baseline and 2 years later. Changes from baseline for each memory and EF outcome were compared between PHEU and PHIV youth with (PHIV/C, n = 39) and without (PHIV/non-C, n = 105) history of CDC class C (AIDS-defining) diagnoses. Among PHIV youth, associations of baseline and past disease severity with memory and EF performance at follow-up were evaluated using adjusted linear regression models.
Participants were primarily black (79%); 16% were Hispanic; 55% were female. Mean memory and EF scores at follow-up generally fell in the low-average to average range. Pairwise comparison of adjusted mean change from baseline to follow-up revealed significantly greater change for PHIV/non-C compared with PHEU youth in only one verbal recognition task, with a difference in mean changes for PHIV/non-C versus PHEU of -0.99 (95% CI: -1.80 to -0.19; P = 0.02). Among youth with PHIV, better immunologic status at baseline was positively associated with follow-up measures of verbal recall and recognition and cognitive inhibition/flexibility. Past AIDS-defining diagnoses and higher peak viral load were associated with lower performance across multiple EF tasks at follow-up.
Youth with PHIV demonstrated stable memory and EF during a 2-year period of adolescence, allowing cautious optimism regarding long-term outcomes.
尽管记忆和执行功能（EF）对于成年后的独立性很重要，但关于围产期获得性HIV感染（PHIV）对青少年时期这些技能纵向变化的影响，人们所知甚少。
12至17岁的PHIV感染者（n = 144）和围产期暴露于HIV但未感染的青少年（PHEU，n = 79）在基线和2年后完成了记忆和EF的标准化测试。比较了有（PHIV/C，n = 39）和没有（PHIV/non-C，n = 105）疾病控制中心C类（艾滋病定义）诊断史的PHEU和PHIV青少年在每个记忆和EF结果上相对于基线的变化。在PHIV青少年中，使用调整后的线性回归模型评估基线和过去疾病严重程度与随访时记忆和EF表现之间的关联。
参与者主要为黑人（79%）；16%为西班牙裔；55%为女性。随访时的平均记忆和EF分数总体上处于低平均到平均范围内。从基线到随访的调整后平均变化的成对比较显示，在仅一项言语识别任务中，PHIV/non-C青少年与PHEU青少年相比有显著更大的变化，PHIV/non-C与PHEU的平均变化差异为-0.99（95%CI：-1.80至-0.19；P = 0.02）。在患有PHIV的青少年中，基线时较好的免疫状态与言语回忆和识别以及认知抑制/灵活性的随访指标呈正相关。过去的艾滋病定义诊断和更高的病毒载量峰值与随访时多项EF任务的较低表现相关。
患有PHIV的青少年在两年的青春期期间表现出稳定的记忆和EF，这使得对长期结果持谨慎乐观态度。
