Perinatal HIV exposure and infection and child executive function.

Abstract

ABSTRACTIn the combined antiretroviral therapy era, limited information exists about cognitive function in children exposed perinatally to human immunodeficiency virus (HIV). To address this, we evaluated executive function (EF) among groups with known HIV exposure status during the perinatal period and at ages 6-10 years: children HIV-infected perinatally (CPHIV, n = 99), children born to HIV-infected mothers, but were HIV negative at enrollment (CPHEU, n = 97), and HIV unexposed, uninfected community controls (CHUU, n = 98). Caregivers completed the Behavior Rating Inventory of Executive Function (BRIEF) to assess two dimensions of child EF (BRI: Behavioral Regulation Index; MCI: Metacognition Index) and a combination of these dimensions (General Executive Composite). We derived Z-scores for BRIEF measures using the CHUU group as the reference and used generalized linear models to estimate mean differences among the groups. The CPHIV and CPHEU groups did not differ from the CHUU group on the GEC or MCI. However, the CPHIV group scored lower than CHUU on the BRI, which is indicative of better functioning in this domain (β = -0.40, 95% CI -0.77, -0.03). Results were unaffected following adjustment. EF scores did not differ substantially across perinatal HIV exposure groups, though we observed evidence that CPHIV may thrive in the BRI domain.