Mwanza-Kabaghe Sylvia, Sportiello Kristen, Shah Mina, Adams Heather R, Mbewe Esau G, Kabundula Pelekelo P, Schneider Colleen, Mweemba Milimo, Birbeck Gretchen L, Bearden David R
Department of Educational Psychology, University of Zambia, Lusaka, Zambia.
University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
medRxiv. 2024 Sep 18:2024.09.17.24313838. doi: 10.1101/2024.09.17.24313838.
Executive function (EF) may be impaired in people with human immunodeficiency virus (HIV) infection, and poor EF may affect medication adherence. However, there is little data on EF in children with HIV in sub-Saharan Africa.
208 children/adolescents with perinatally acquired HIV and 208 HIV-exposed uninfected controls were recruited in Zambia for this prospective cohort study. EF was measured using performance-based, self-report, and parental report measures. Adherence over one year of follow-up was assessed through questionnaires and viral load measurement.
Children with HIV performed significantly worse on all three measures of EF. Lower parental rating of EF was associated with poorer antiretroviral therapy adherence (OR: 1.5, 95% CI = 1.02 - 2.2, p = 0.04).
Children with HIV have EF impairments which may lead to consequences like poor medication adherence and treatment failure. Interventions to improve EF or compensate for impaired EF may be necessary in this population.
人类免疫缺陷病毒（HIV）感染者的执行功能（EF）可能受损，而EF较差可能会影响药物依从性。然而，关于撒哈拉以南非洲地区HIV感染儿童的EF数据很少。
在赞比亚招募了208名围产期感染HIV的儿童/青少年和208名未感染HIV但暴露于HIV的对照儿童，进行这项前瞻性队列研究。使用基于表现、自我报告和家长报告的测量方法来评估EF。通过问卷调查和病毒载量测量评估一年随访期内的依从性。
HIV感染儿童在所有三项EF测量指标上的表现均显著较差。家长对EF的评分较低与抗逆转录病毒治疗依从性较差相关（比值比：1.5，95%置信区间=1.02 - 2.2，p = 0.04）。
HIV感染儿童存在EF受损情况，这可能导致药物依从性差和治疗失败等后果。对于这一人群，可能需要采取干预措施来改善EF或弥补受损的EF。
