Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning.
Impact of Perinatally Acquired HIV Disease Upon Longitudinal Changes in Memory and Executive Functioning.
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DOI：
10.1097/qai.0000000000001441
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发表时间：
2017-08-01
期刊：
影响因子：
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通讯作者：
Memory and Executive Functioning Study of the Pediatric HIV/AIDS Cohort Study
中科院分区：
文献类型：
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作者：
Malee KM;Chernoff MC;Sirois PA;Williams PL;Garvie PA;Kammerer BL;Harris LL;Nozyce ML;Yildirim C;Nichols SL;Memory and Executive Functioning Study of the Pediatric HIV/AIDS Cohort Study
尽管围产期获得性 HIV 感染 (PHIV) 对青春期记忆和执行功能 (EF) 纵向变化的影响，人们知之甚少，尽管这些技能对于成年后的独立很重要。 PHIV (n=144) 和围产期 HIV 暴露的未感染青少年 (PHEU, n=79)（年龄 12-17 岁）在基线和两年后完成了记忆力和 EF 的标准化测试。比较了有（PHIV/C，n=39）和无（PHIV/非 C，n=105）CDC C 类（艾滋病定义）诊断史的 PHEU 和 PHIV 青年之间每个记忆和 EF 结果相对于基线的变化。在 PHIV 青少年中，使用调整后的线性回归模型评估基线和既往疾病严重程度与随访时记忆力和 EF 表现的关联。参与者主要是黑人（79%）； 16% 是西班牙裔； 55%是女性。随访时的平均记忆力和 EF 分数普遍落在低平均到平均范围内。从基线到随访的调整后平均变化的两两比较显示，仅在一项言语识别任务中，PHIV/non-C 与 PHEU 青年相比，PHIV/non-C 青年的变化显着更大，PHIV/non-C 与 PHEU 的平均变化差异为 -0.99 (95% CI: -1.80, -0.19; p=0.02)。在感染 PHIV 的青少年中，基线时较好的免疫状态与言语回忆和识别以及认知抑制/灵活性的后续测量呈正相关。过去的艾滋病定义诊断和较高的峰值病毒载量与随访时多项 EF 任务的较低表现相关。患有 PHIV 的青少年在两年的青春期表现出稳定的记忆力和 EF，这使得他们对长期结果保持谨慎乐观。
Little is known regarding effects of perinatally-acquired HIV infection (PHIV) on longitudinal change in memory and executive functioning (EF) during adolescence, despite the importance of these skills for independence in adulthood. PHIV (n=144) and perinatally HIV-exposed uninfected youth (PHEU, n=79), ages 12–17, completed standardized tests of memory and EF at baseline and two years later. Changes from baseline for each memory and EF outcome were compared between PHEU and PHIV youth with (PHIV/C, n=39) and without (PHIV/non-C, n=105) history of CDC Class C (AIDS-defining) diagnoses. Among PHIV youth, associations of baseline and past disease severity with memory and EF performance at follow-up were evaluated using adjusted linear regression models. Participants were primarily black (79%); 16% were Hispanic; 55% were female. Mean memory and EF scores at follow-up generally fell in the low-average to average range. Pairwise comparison of adjusted mean change from baseline to follow-up revealed significantly greater change for PHIV/non-C compared to PHEU youth in only one verbal recognition task, with a difference in mean changes for PHIV/non-C versus PHEU of −0.99 (95%CI: −1.80, −0.19; p=0.02). Among youth with PHIV, better immunologic status at baseline was positively associated with follow-up measures of verbal recall and recognition and cognitive inhibition/flexibility. Past AIDS-defining diagnoses and higher peak viral load were associated with lower performance across multiple EF tasks at follow-up. Youth with PHIV demonstrated stable memory and EF during a two-year period of adolescence, allowing cautious optimism regarding long-term outcomes.