Currently, the vast majority of children living with HIV live in sub-Saharan Africa. Although early antiretroviral therapy (ART) has ensured a reduction in mortality among children infected with and exposed to HIV, studies have shown that the virus can still affect the brain. HIV can disrupt neurodevelopment and affect children’s learning, reasoning and functional development.
Professor Michael Boivin, director of the Psychiatry Research Program at Michigan State University School of Orthopaedic Medicine, and others published a two-year longitudinal study in the journal Clinical Infectious Diseases. The study is designed to understand the impact of HIV on the neuropsychological development of children.
Boivin and colleagues assessed neuropsychological development in three groups of children aged 5-11: children who were infected with HIV during perinatal and underwent antiretroviral therapy;
The study was conducted at six research sites in four countries in sub-Saharan Africa to gain insight into how HIV affects children in the region. To date, this is the first effective multi-point neuropsychological assessment of HIV-affected African school-age children.
Through various assessments, the researchers found that even after early treatment and good clinical care, HIV-carrying children still have serious neuropsychological problems.
“Compared to other children of the same age, these children developed defects in the study. “In these two years, an important area: reasoning and computing, remain edgy. In this particular testing area, children living with HIV do not make progress over time. “
In other words, the gap between infected and HIV-negative children grew during the study period in terms of calculation and reasoning. In general, in healthy children, these abilities tend to become increasingly good at school age.
And this is actually the most important cognitive function for the future of HIV-infected children. “Because they are likely to take drugs, make the right decisions and avoid risky behaviors such as premature sexual behavior, psychosocial problems, and academic-related achievements,” Boivin said. “
The team also noted that early treatment, which begins at six months of age, may not be enough to address HIV-related neurocognitive impairments, although it helps children survive more likely than treatment. For these children, treatment should begin earlier to improve long-term neurocognitive outcomes.
“We will have to supplement long-term care and support with practical behavioral interventions,” Boivin said.
That’s what Boivin and his colleagues are already working on. Earlier this year, Boivin received a five-year, $3.2 million grant from the National Institutes of Health (NIH) to continue researching children affected by AIDS in Uganda and Malawi. With this funding, researchers will study how computer cognitive games developed by Michigan State University can be used as tools for neurocognitive assessment, enrichment and potential rehabilitation.
Boivin hopes that the results of these two studies will help this neuropsychological assessment model to be part of the cost-effectiveness of caring for children living with HIV.
“Usually this is overlooked or thought of in hindsight, but unlike other areas of medical follow-up, neuropsychological assessments are really focused on children’s adaptability and function in schools, families, communities, and society as a whole. “This is really something that most directly relates us to the burden of human disease. “