BACKGROUND:Lifelong HIV and antiretroviral therapy may confer neurodevelopmental risk on the children of women with perinatally acquired HIV infection (PHIV). SETTING:We analyzed data from HIV-exposed uninfected (HEU) infants born to women with PHIV vs. non-perinatally acquired HIV (NPHIV) enrolled in the Surveillance Monitoring for Antiretroviral Therapy Toxicities (SMARTT) study. METHODS:Using the Bayley Scales of Infant and Toddler Development, third Ed. (Bayley-III), we compared neurodevelopmental outcomes at the age of 1 year in HEU infants born to women with PHIV vs. NPHIV. Those with valid Bayley-III data at the age of 1 year and a mother born after 1982 were included. Cognitive, language, and motor domains were assessed as continuous composite scores. Linear mixed effects models were fit to estimate the mean difference in Bayley-III scores between groups, adjusting for confounders. RESULTS:Five hundred fifty women with HIV gave birth to 678 HEU children (125 and 553 born to women with PHIV and NPHIV, respectively). Mean scores for each of the Bayley-III domains were not significantly different between infants born to women with PHIV vs. NPHIV in unadjusted models. After adjustment, infants of women with PHIV had lower language (91.9 vs. 94.8, P = 0.05) and motor (93.7 vs. 96.8, P = 0.03) composite scores, but no differences in cognitive composite scores. CONCLUSIONS:Cognitive domain outcomes of infants born to women with PHIV vs. NPHIV are reassuring. Differences in early language and motor functioning, while of modest clinical significance, highlight the importance of long-term monitoring of neurodevelopment in children of women with PHIV.

译文

背景:终身艾滋病毒和抗逆转录病毒疗法可能会给围生期获得性HIV感染(PHIV)的妇女的孩子带来神经发育风险。
地点:我们分析了参加抗逆转录病毒疗法毒性监测监测(SMARTT)研究的PHIV妇女与非感染性HIV(NPHIV)所生的HIV暴露未感染(HEU)婴儿的数据。
方法:使用贝利婴儿和幼儿发展量表,第三版。 (Bayley-III),我们比较了PHIV与NPHIV妇女所生的HEU婴儿在1岁时的神经发育结局。包括那些在1岁时具有有效Bayley-III数据并在1982年之后出生的母亲。认知,语言和运动领域被评估为连续综合评分。线性混合效应模型适合估计各组之间Bayley-III得分的平均差异,并针对混杂因素进行了调整。
结果:550名艾滋病毒妇女分娩了678名HEU儿童(分别由PHIV和NPHIV妇女分娩的125和553名)。在未经调整的模型中,患有PHIV和NPHIV的妇女所生婴儿的每个Bayley-III域平均得分没有显着差异。调整后,患有PHIV的女性婴儿的语言综合评分较低(91.9 vs. 94.8,P = 0.05)和运动评分(93.7 vs. 96.8,P = 0.03),但认知综合评分没有差异。
结论:PHIV vs. NPHIV患儿所生婴儿的认知领域结局令人放心。早期语言和运动功能的差异尽管具有一定的临床意义,但突出了对PHIV女性儿童的神经发育进行长期监测的重要性。

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