Department of Paediatrics & Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Ukwanda Centre for Rural Health, Worcester, South Africa.
Trop Med Int Health. 2018 Jan;23(1):69-78. doi: 10.1111/tmi.13006. Epub 2017 Dec 7.
To compare neurodevelopmental outcomes of HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) infants in a peri-urban South African population. HEU infants living in Africa face unique biological and environmental risks, but uncertainty remains regarding their neurodevelopmental outcome. This is partly due to lack of well-matched HUU comparison groups needed to adjust for confounding factors.
This was a prospective cohort study of infants enrolled at birth from a low-risk midwife obstetric facility. At 12 months of age, HEU and HUU infant growth and neurodevelopmental outcomes were compared. Growth was evaluated as WHO weight-for-age, length-for-age, weight-for-length and head-circumference-for-age Z-scores. Neurodevelopmental outcomes were evaluated using the Bayley scales of Infant Development III (BSID) and Alarm Distress Baby Scale (ADBB).
Fifty-eight HEU and 38 HUU infants were evaluated at 11-14 months of age. Performance on the BSID did not differ in any of the domains between HEU and HUU infants. The cognitive, language and motor scores were within the average range (US standardised norms). Seven (12%) HEU and 1 (2.6%) HUU infant showed social withdrawal on the ADBB (P = 0.10), while 15 (26%) HEU and 4 (11%) HUU infants showed decreased vocalisation (P = 0.06). There were no growth differences. Three HEU and one HUU infant had minor neurological signs, while eight HEU and two HUU infants had macrocephaly.
Although findings on the early neurodevelopmental outcome of HEU infants are reassuring, minor differences in vocalisation and on neurological examination indicate a need for reassessment at a later age.
在南非一个城市周边地区，比较感染 HIV 的未感染者（HEU）和未感染 HIV 的未感染者（HUU）婴儿的神经发育结果。生活在非洲的 HEU 婴儿面临着独特的生物和环境风险，但他们的神经发育结果仍存在不确定性。这在一定程度上是由于缺乏能够调整混杂因素的匹配良好的 HUU 对照组。
这是一项在低风险助产士产科设施中从出生开始入组的婴儿前瞻性队列研究。在 12 个月龄时，比较 HEU 和 HUU 婴儿的生长和神经发育结果。生长情况通过 WHO 体重-年龄、身长-年龄、体重-身长和头围-年龄 Z 评分来评估。神经发育结果使用贝利婴幼儿发育量表第三版（BSID）和婴儿警报 distress 量表（ADBB）进行评估。
58 名 HEU 和 38 名 HUU 婴儿在 11-14 个月龄时进行了评估。在任何领域，HEU 和 HUU 婴儿的 BSID 表现均无差异。认知、语言和运动评分均处于平均范围（美国标准化标准）。7 名（12%）HEU 和 1 名（2.6%）HUU 婴儿在 ADBB 上表现出社交回避（P = 0.10），而 15 名（26%）HEU 和 4 名（11%）HUU 婴儿表现出发声减少（P = 0.06）。生长差异无统计学意义。3 名 HEU 和 1 名 HUU 婴儿有轻微的神经系统体征，而 8 名 HEU 和 2 名 HUU 婴儿有大头畸形。
尽管 HEU 婴儿早期神经发育结果令人欣慰，但在发声和神经系统检查方面存在微小差异，表明需要在以后的年龄进行重新评估。
