Cognitive impairments in Polish children and adolescents with perinatal HIV infection. / Zaburzenia poznawcze u dzieci i mlodziezy z wrodzonym zakazeniem HIV w Polsce.

OBJECTIVES: The aim of the study was to assess the presence of cognitive impairments in children and adolescents with vertically transmitted HIV infection and to determine possible relationships with clinical and socio-demographic variables. METHODS: Fifty children with perinatal HIV infection aged 6-18 years were included in the experimental group (PHIV+). Two sex- and age-matched groups were recruited as reference groups: (1) a PHEU group that included 24 healthy children perinatally HIV-exposed but uninfected, and (2) an HIV-nA group that included 43 healthy children of uninfected parents. CANTAB Research Suite was used to assess cognitive functioning. RESULTS: In comparison with the HIV-nA group, the PHIV+ group scored worse in movement execution, shifting and flexibility of attention, reversal learning and working memory. In comparison with the PHEU group, the PHIV+ group had significantly longer planning time in the memory task. The analysis of results for the 12-18 year-old age group revealed deterioration of cognitive functions in all tests of the PHIV+ children in comparison with the HIV-nA group. A higher logarithm of viral load at the start of the ARV treatment was associated with worse results in the use of feedback, shifting of attention, cognitive flexibility and worse information processing. CONCLUSIONS: Results of the research indicate deterioration of executive functioning in the PHIV+ group associated with longer duration of HIV neuroinfection and severity of infection before treatment.

Psychiatric, behavioral and emotional disorders in Polish children and adolescents with perinatal HIV infection. / Zaburzenia psychiczne, behawioralne i emocjonalne u dzieci i mlodziezy z wrodzonym zakazeniem HIV w Polsce.

OBJECTIVES: The aims of the study were to evaluate the prevalence of psychiatric, behavioral and emotional disorders in children and adolescents with perinatal HIV infection and to establish their possible relationships with clinical and sociodemographic variables. METHODS: 56 children with perinatal HIV infection (PHIV+ group), 24 healthy children perinatally HIV-exposed but uninfected (PHEU) and 43 healthy children of uninfected parents (HIV-nA), aged 6-18 years, were assessed. The Child Behavior Checklist (CBCL/4-18), completed by parents, and the Youth Self-Report (YSR) were used to assess behavioral and emotional disorders, while the semi-structured diagnostic interview K-SADS-PL was used to assess the symptoms of psychiatric disorders. RESULTS: Higher prevalence of psychiatric disorders was found in the PHIV+ group and the PHEU group compared to the HIV-nAgroup. Anxiety disorders and affective disorders were diagnosed most often. Prevalence of symptoms of emotional and behavioral disorders in the PHIV+ group and in the PHEU group was associated with similar sociodemographic variables (male, not living with the biological caregiver, the experience of stressful life events). Psychiatric disorders were noted more often among PHIV+ subjects whose ARV treatment was started after 12 months of age. Positive correlations were observed between the results of some YSR and CBCL/4-18 problem scales and CD4 counts at the time of the study, higher logarithm of viral load at the start of ARV treatment and at the time of HIV diagnosis. CONCLUSIONS: The prevalence of psychiatric disorders in PHIV+ group and the PHEU group is higher in comparison with HIV-nAgroup. Amore serious course of HIV infection and its severity before treatment are associated with the severity of internalizing problems.

Health-related quality of life in Polish children and adolescents with perinatal HIV infection - short report.

The aims of the study were to assess health-related quality of life (HRQoL) in children and adolescents with perinatal HIV infection and to establish possible relationships with clinical and socio-demographic variables. About 56 children with perinatal HIV infection, aged 6-18 years (PHIV+ group), 24 healthy perinatally HIV-exposed but uninfected (PHEU) children, and 43 children HIV-unexposed uninfected (HUU) were assessed using the PedsQL 4.0. Generic Core. The perceptions of school functioning according to children and social functioning, according to parents, were worse in the PHIV+ group compared to those in the PHEU group. In comparison to the HUU group, PHIV+ children received lower total HRQoL scores in the caregivers' perception. Most of the life-quality indices increased systematically with age in PHIV+ group, whereas opposite trends were present in both control groups. Caregivers of children with a final CDC category C and caregivers of children diagnosed with encephalopathy perceived most domains of their children functioning as more problematic. A more serious course and more severe HIV infection before treatment were associated with worse multidimensional functioning and a worse total HRQoL score. Results highlight the importance of early diagnosis and treatment initiation as having significant implications for the quality of life.