赞比亚感染人类免疫缺陷病毒儿童的纵向认知结果(2939)

摘要目的:确定围产期获得性人类免疫缺陷病毒(HIV)儿童认知结局的预测因素。

背景:多项先前的研究表明，与未感染艾滋病毒的儿童相比，感染艾滋病毒的儿童表现出发育迟缓和认知受损。然而，关于艾滋病毒感染儿童的纵向认知结果的数据有限。

设计/方法:我们进行了一项前瞻性队列研究，包括208名8-17岁的围产期感染艾滋病毒的儿童和208名暴露于艾滋病毒未感染(HEU)的对照组，以评估长期认知功能。所有参与者随访2年，每3个月收集一次重复测量。通过综合神经心理测试评估认知能力，并为每位参与者生成认知总结评分。最初的模型包括HIV+和HEU参与者，随后是针对HIV+参与者的单独模型，以评估HIV特异性变量的贡献。使用双变量和多变量回归模型以及基于群体的轨迹建模，探讨了健康相关变量、营养状况、艾滋病毒疾病严重程度和社会经济状况对基线和纵向认知结果的相对贡献。

结果:在双变量分析中，艾滋病毒与基线时较差的认知能力密切相关(β−13.7,95% CI−20.5至−6.8,p<0.001)。在HIV特异性模型中，认知功能最强的预测因素包括社会经济地位(β 3.0, 95% CI 0.98-5.0, p=0.004)， WHO阶段(β - 11.4, 95% CI - 22.2 -)。057, p=0.04)，自我报告健康状况不佳(β−18.8,95% CI−37.7至0.02,p=0.05)。基于组的轨迹建模确定了三个组。HIV+状态预示着认知轨迹表现最差(OR 2.3, p=0.006)。在预测轨迹成员的HIV特定模型中，最强的预测因素再次包括社会经济地位、自我报告的健康状况不佳和世卫组织阶段。

结论:携带艾滋病毒的儿童有认知能力差的风险。针对认知结果不良的主要风险因素的有针对性的干预措施对于改善这一人群的认知结果是必要的。

披露:帕蒂尔没有什么可透露的。汉娜·史密斯没有什么可透露的。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。 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.