Neurodevelopmental delays in children with perinatally acquired human immunodeficiency virus infection, with respect to antiretroviral therapy initiation and virological suppression

Simple item page
dc.contributor.authorStrehlau, Renate
dc.date.accessioned2014-02-06T13:20:03Z
dc.date.available2014-02-06T13:20:03Z
dc.date.issued2013
dc.descriptionA research report submitted to the Faculty of Health Sciences, the University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine in Child Health Neurodevelopment Johannesburg, 2013
dc.description.abstractHuman Immunodeficiency Virus (HIV) infection in infancy may influence the developing brain and lead to adverse neurodevelopmental consequences. We aim to describe the neurodevelopmental characteristics of a cohort of young children infected with HIV prior to antiretroviral therapy (ART) initiation and after achieving viral suppression. A retrospective analysis of data collected as part of a randomised equivalence trial between April 2005 and May 2009, at a hospital in Johannesburg, South Africa. 195 HIV-infected children under 2 years of age were assessed. A simple, inexpensive screening questionnaire (Ages and Stages Questionnaire - ASQ) was used to identify neurodevelopmental delays. The ASQ was administered prior to ART initiation, and again after viral suppression on a protease inhibitor-based regimen had been achieved. Median age pre-ART was 8.8 months (range 2.2 - 24.9), 53.9% were male. Mean time to viral suppression was 9.4 months (range 5.9 - 14.5) and the ASQ was administered to 108 caregivers at this time. Compared to pre-ART, at viral suppression, there was significant reduction in the proportion of children failing the gross motor (31.5% vs. 13%, p<0.01), fine motor (21.3% vs. 10.2%, p=0.02), problem solving (26.9% vs. 9.3%, p<0.001) and personal social (17.6% vs. 7.4%, p=0.02) domains. The proportion of children failing the communication domain was similar at each time point (14.8% vs. 12%, p=0.61). At time of viral suppression 10.2% failed at least one of the five domains. Achieving viral suppression on ART resulted in significant improvements in the neurodevelopmental function of young HIV-infected children, however, neurodevelopmental problems still persisted in a large proportion. Appropriate screening for neurodevelopmental delay and timely referral could help improve outcomes.en_ZA
dc.identifier.urihttp://hdl.handle.net10539/13684
dc.language.isoenen_ZA
dc.subject.meshAntiretroviral Therapy, Highly Active
dc.subject.meshCentral Nervous System--growth & development
dc.subject.meshHIV Infections
dc.subject.meshInfant
dc.subject.meshChild
dc.titleNeurodevelopmental delays in children with perinatally acquired human immunodeficiency virus infection, with respect to antiretroviral therapy initiation and virological suppressionen_ZA
dc.typeThesisen_ZA
Files
Original bundle
Now showing 1 - 3 of 3
No Thumbnail Available
Name:
Strehlau Research Report 9802279Y 04June2013.pdf
Size:
583.15 KB
Format:
Adobe Portable Document Format
Download
No Thumbnail Available
Name:
APPENDIX I AGES and STAGES QUESTIONNAIRES.pdf
Size:
2.39 MB
Format:
Adobe Portable Document Format
Download
No Thumbnail Available
Name:
APPENDIX II HREC Approval Letter.TIF
Size:
26.5 KB
Format:
Tag Image File Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
ETD Collection