García-Navarro C, Jimenez de Ory S, Velo Higueras C, Zamora B, Prieto L, Ramos J T, Navarro M L, Escosa-García L, Jurado-Barba R, Falcón Dolores, Moreno David, González-Tomé M I
Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain.
Research Institute Hospital 12 de Octubre (i+12), Spain.
Heliyon. 2020 Apr 25;6(4):e03600. doi: 10.1016/j.heliyon.2020.e03600. eCollection 2020 Apr.
Delayed neurodevelopment is a common outcome in perinatally HIV-infected children. Our aim was to assess the intellectual profile of our cohort, considering both the infection and socio-environmental related variables. A cross-sectional cohort study was undertaken at seven major hospitals in Spain belonging to the CoRISpeS cohort (n = 97). Patients were followed up according to a standard protocol. Intellectual measures, psychosocial profile and HIV infection-related data have been analysed. The average patient age was 15 years. The median CD4 cell percentage was 35% (1,59). Viral load was undetectable in 80% of the patients and 27% were on AIDS category; 38% of whom had encephalopathy. The average composite score of both crystallized intelligence (CI) and intelligence quotient (IQ) for the cohort was lower than that of the general population (p < 0.001). Results revealed a significant difference of 38% between crystallized and fluid intelligence. There was a clear association between IQ and age of diagnosis (p = 0.022); CI and CDC classification (p = 0.035), CD4 count (p = 0.011) and CD4 nadir (p = 0.001). Higher parental education was associated with better performance across all intelligence scales (p < 0.002). A regression model showed that CI was influenced by the academic level of caregivers (p = 0.002), age at start of cART (p = 0.050) and primary language (p = 0.058). Findings revealed significant differences in verbal and non-verbal intellectual scales resulting in a misleading IQ Composite score Crystallized intelligence demonstrated the highest level of impairment despite adequate treatment and good immunovirological status, while fluid intelligence results were average. Caregiver level of education was the strongest factor across all intelligence measures.
神经发育迟缓是围产期感染艾滋病毒儿童的常见后果。我们的目的是评估我们队列的智力状况,同时考虑感染和社会环境相关变量。在西班牙属于CoRISpeS队列的七家主要医院进行了一项横断面队列研究(n = 97)。患者按照标准方案进行随访。分析了智力测量、心理社会状况和与艾滋病毒感染相关的数据。患者的平均年龄为15岁。CD4细胞百分比中位数为35%(1,59)。80%的患者病毒载量检测不到,27%属于艾滋病类别;其中38%患有脑病。该队列的晶体智力(CI)和智商(IQ)的平均综合得分低于一般人群(p < 0.001)。结果显示晶体智力和流体智力之间存在38%的显著差异。智商与诊断年龄之间存在明显关联(p = 0.022);晶体智力与疾病控制中心分类(p = 0.035)、CD4计数(p = 0.011)和CD4最低点(p = 0.001)之间存在明显关联。父母教育程度越高,在所有智力量表上的表现越好(p < 0.002)。回归模型显示晶体智力受照顾者的学术水平(p = 0.002)、开始抗逆转录病毒治疗的年龄(p = 0.050)和主要语言(p = 0.058)影响。研究结果显示言语和非言语智力量表存在显著差异,导致智商综合得分产生误导。尽管接受了充分治疗且免疫病毒学状况良好,但晶体智力受损程度最高,而流体智力结果为平均水平。照顾者的教育程度是所有智力测量中最强的因素。