[A prospective study of neurodevelopment of uninfected children born to human immunodeficiency virus type 1 positive mothers]. / Estudio prospectivo comparativo sobre el desarrollo psicomotor de niños, nacidos de madres positivas para el virus de inmunodeficiencia humana tipo 1 no infectados.

INTRODUCTION: The human immunodeficiency virus type 1 (HIV-1) has tropism for the immune and central nervous systems (CNS). Intrauterine exposure to HIV-1 induces immunological alterations, independent of infection that might affect the development of the CNS. Similarly, the intrauterine exposure to antiretrovirals might also affect the neurodevelopment. AIM: To evaluate the neurodevelopment of babies born to HIV-1 positive mothers (exposed) and compare with babies born to HIV-1 negative mothers (unexposed). SUBJECTS AND METHODS: We carried-out an observational prospective study of neurodevelopment of 23 exposed and 20 unexposed children using the infant development scale Bayley-II, and the Denver-II test, neurological examination and anthropometric measurements during the first two years of life. RESULTS: None of the exposed babies acquired the infection. At one month of age the exposed babies exhibit normal but statistically lower values in the head circumference, compared to unexposed neonates. No differences were found in the psychomotor development index between both studied groups and exposed babies exhibited a lower mental development index but only at six months of age. The exposed babies exhibited a higher number of alterations during the neurological and Denver-II tests without reaching significant differences. CONCLUSIONS: The results suggest that intrauterine exposure to HIV-1 and to antiretrovirals in uninfected children born to HIV-1 positive mothers does not induce alterations in the neurodevelopment, at least during the first two years of life.

Estudio prospectivo comparativo sobre el desarrollo psicomotor de niños, nacidos de madres positivas para el virus de inmunodeficiencia humana tipo 1 no infectados / A prospective study of neurodevelopment of uninfected children born to human inmunodeficiency virus type 1 positive mothers

Introducción. El virus de inmunodeficiencia humana tipo 1 (VIH-1) tiene tropismo por células del sistema inmune y del sistema nervioso central (SNC). La exposición intrauterina al VIH-1 causa alteraciones inmunológicas, con independencia de que el recién nacido adquiera la infección, que pueden afectar al desarrollo del SNC; además, la exposición a los antirretrovirales puede también afectar al desarrollo psicomotor. Objetivo. Evaluar el desarrollo psicomotor en niños nacidos de madres VIH-1 positivas (expuestos), y compararlos con niños sin el antecedente de la exposición al VIH-1. Sujetos y métodos. Se realizó un estudio prospectivo observacional acerca del desarrollo psicomotor de 23 niños expuestos y 20 niños no expuestos, empleando la escala de Bayley-II, el test de Denver-II y un examen neurológico, durante los primeros dos años de vida. Resultados. Los niños expuestos continuaron sin presentar la infección. Al mes de edad, los niños expuestos tuvieron valores de perímetro cefálico normales, pero menores, que los niños no expuestos. No se detectaron diferencias en el índice de desarrollo psicomotor, y el índice de desarrollo mental, sólo en el sexto mes, fue significativamente menor en los niños con exposición al VIH-1. El grupo de niños expuestos presentó más alteraciones en el test de Denver-II y en el examen neurológico, aunque sin alcanzar diferencias significativas. Conclusiones. Los resultados indican que la exposición intrauterina al VIH-1 y a los antirretrovirales de los niños que no adquieren la infección no causa alteraciones del desarrollo psicomotor al menos durante los primeros dos años de vida (AU)

Introduction. The human immunodeficiency virus type 1 (HIV-1) has tropism for the immune and central nervous systems (CNS). Intrauterine exposure to HIV-1 induces immunological alterations, independent of infection that might affect the development of the CNS. Similarly, the intrauterine exposure to antiretrovirals might also affect the neurodevelopment. Aim. To evaluate the neurodevelopment of babies born to HIV-1 positive mothers (exposed) and compare with babies born to HIV-1 negative mothers (unexposed). Subjects and methods. We carried-out an observational prospective study of neurodevelopment of 23 exposed and 20 unexposed children using the infant development scale Bayley-II, and the Denver-II test, neurological examination and anthropometric measurements during the first two years of life. Results. None of the exposed babies acquired the infection. At one month of age the exposed babies exhibit normal but statistically lower values in the head circumference, compared to unexposed neonates. No differences were found in the psychomotor development index between both studied groups and exposed babies exhibited a lower mental development index but only at six months of age. The exposed babies exhibited a higher number of alterations during the neurological and Denver-II tests without reaching significant differences. Conclusions. The results suggest that intrauterine exposure to HIV-1 and to antiretrovirals in uninfected children born to HIV-1 positive mothers does not induce alterations in the neurodevelopment, at least during the first two years of life (AU)