赞比亚艾滋病毒感染儿童和青少年认知和抑郁的纵向分析(2521)

摘要目的:在赞比亚艾滋病毒感染儿童和青少年的纵向研究中，确定抑郁症和认知功能之间的关系。

背景:我们和其他人之前曾描述过艾滋病毒感染儿童的抑郁症和认知障碍之间的联系。然而，先前的研究受到横断面设计的限制。

设计/方法:HANDZ研究是一项前瞻性纵向队列研究，包括208名接受抗逆转录病毒治疗(ART)的围产期感染艾滋病毒的儿童和208名8-17岁的未感染艾滋病毒(HEU)儿童。使用综合神经心理学测试评估认知能力，使用NIH工具箱悲伤模块和PHQ-9的自我报告和父母报告评估抑郁症状。基于组的轨迹模型被用来确定随着时间的推移遵循相似轨迹的参与者的子组，双轨迹模型被用来评估认知功能和抑郁之间的纵向关系。采用结构方程模型研究抑郁与认知之间的因果关系。

结果:随着时间的推移，感染艾滋病毒的儿童在抑郁症状和认知功能方面都有所改善，尽管与感染艾滋病毒的未感染对照组相比，他们的抑郁程度仍然显著更高，认知功能也更差。抑郁情绪与认知障碍密切相关(未调整OR=3.3, 95% CI 1.5-7.5, p=0.004)。抑郁症和认知障碍有许多重叠的风险因素，包括较低的社会经济地位、健康状况不佳、不良的童年经历和生长迟缓。双轨迹模型表明，随着时间的推移，认知功能与抑郁呈反比关系，基线抑郁症状预示着认知表现最低的组的成员。

结论:艾滋病毒与抑郁症和认知障碍显著相关，而且这种关联会随着时间的推移而持续存在。需要进一步的研究来确定抑郁症和认知障碍是否都是艾滋病毒相关神经认知障碍的一部分，或者这种关联是否由其他因素驱动。

披露:汉娜·史密斯没有什么可透露的。帕蒂尔没有什么可透露的。希瑟·亚当斯研究所获得了来自美国国立卫生研究院的研究支持;过去:Abeona;巴顿研究联盟;美国大学残疾研究中心。希瑟·亚当斯(Heather Adams)的直系亲属获得了一份与医疗保健有关的出版物的版税。希瑟·亚当斯(Heather Adams)担任关键路径研究所(Critical Path Institute)顾问，获得了500- 4,999美元的个人报酬。Esau G. Mbewe没有什么可透露的。Pelekelo kula没有什么可透露的。 Sylvia Mwanza-Kabaghe has nothing to disclose. Michael Potchen has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Jackson & Campbell, P.C.. Michael Potchen has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Rotezel & Andress. Dr. Birbeck has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for American Neurological Association. An immediate family member of Dr. Birbeck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. The institution of Dr. Birbeck has received research support from NIH. The institution of an immediate family member of Dr. Birbeck has received research support from RSNA. Dr. Birbeck has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board with NIH FIC. Dr. Birbeck has a non-compensated relationship as a Ambassador for Zambia with RSTMH that is relevant to AAN interests or activities. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Bearden has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for law firms.