Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York City, New York, USA.
Child Care Health Dev. 2021 Mar;47(2):154-162. doi: 10.1111/cch.12828. Epub 2020 Nov 20.
Neurodevelopmental stimulation programmes can improve developmental outcomes. Antiretroviral therapy (ART) started soon after birth potentially limits the invasion of HIV into the central nervous system. A combination of developmental stimulation and early ART initiation may reduce developmental delays in children with perinatally acquired HIV infection.
At a single site in Johannesburg, South Africa, we enrolled 36 HIV-infected neonates on ART into an intervention group (IG) participating in a yearlong home-based, neurodevelopmental stimulation programme. Bayley Scales of Infant and Toddler Development-3rd Edition (BSID-III) assessments were conducted at 12 months. Scores were compared with 24 early treated HIV-infected infants in an observational group (OG). BSID-III assessments were also conducted for older children in an OG at 24 or 36 months. Cognitive, language and motor scaled and composite scores were analysed.
BSID-III scaled and composite scores were all higher in the IG apart from the gross motor scaled score (9.25 vs. 10, p = 0.1954). Receptive communication scaled score was significantly higher in the IG (10.96 vs. 9, p = 0.0331). IG composite scores were all higher than OG scores. OG children assessed at 24 or 36 months had lower composite scores in all subscales than 12-month OG scores.
Early treated HIV-infected children participating in a neurodevelopmental stimulation programme achieved higher BSID-III scores at 12 months compared with early treated HIV-infected children who did not receive the programme.
神经发育刺激方案可以改善发育结果。出生后尽快开始抗逆转录病毒治疗（ART）可潜在限制 HIV 对中枢神经系统的侵袭。发育刺激与早期 ART 启动相结合，可能会减少经母婴传播感染 HIV 的儿童的发育迟缓。
在南非约翰内斯堡的一个单一地点，我们将 36 名接受 ART 治疗的 HIV 感染新生儿纳入干预组（IG），参与为期一年的家庭神经发育刺激计划。在 12 个月时进行贝利婴幼儿发展量表第三版（BSID-III）评估。将评分与 24 名接受早期治疗的 HIV 感染婴儿（观察组，OG）进行比较。OG 中的较大儿童在 24 或 36 个月时也进行 BSID-III 评估。分析认知、语言和运动评分和综合评分。
IG 的 BSID-III 评分和综合评分均高于 OG，除粗大运动评分外（9.25 与 10，p=0.1954）。IG 的接受性沟通评分也明显更高（10.96 与 9，p=0.0331）。IG 的综合评分均高于 OG。在 24 或 36 个月时进行评估的 OG 儿童在所有子量表中的综合评分均低于 12 个月 OG 儿童。
参与神经发育刺激计划的早期治疗 HIV 感染儿童在 12 个月时获得的 BSID-III 评分高于未接受该计划的早期治疗 HIV 感染儿童。
