Immunological correlates of behavioral problems in school-aged children living with HIV in Kayunga, Uganda.
Immunological correlates of behavioral problems in school-aged children living with HIV in Kayunga, Uganda.
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乌干达Kayunga的学龄儿童行为问题的免疫学相关性。
DOI：
10.1017/gmh.2015.7
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Boivin M
中科院分区：
文献类型：
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作者：
Ruiseñor-Escudero H;Familiar I;Nakasujja N;Bangirana P;Opoka R;Giordani B;Boivin M
艾滋病毒会影响儿童的神经心理功能，包括他们的行为。我们的目标是确定乌干达艾滋病毒感染儿童行为问题的免疫学相关性。在乌干达卡永加进行的一项父母随机对照试验中，采用执行功能行为评定量表（BRIEF）和儿童行为量表（CBCL）对儿童进行了评估。我们构建了简单和多元线性回归模型，以确定行为问题的免疫相关性。共有144名感染艾滋病毒的儿童（50%为男性），平均年龄为8.9岁[标准差（s.d.） = 1.9]纳入分析。82名儿童正在接受抗逆转录病毒治疗。平均CD 4细胞计数%为35.1个细胞/μl（s.d. = 15.0），平均CD 4细胞活化率为5.7%（s.d. = 5.1），平均CD 8细胞活化率为17.5%（s.d. = 11.2），60名儿童（41.7%）的病毒载量<4000拷贝/ml。在调整后的BRIEF模型中，更高的分数与更高的病毒载量相关（aβ = 16.7 × 10−6，95% CI-5.00 × 10−6至28.4 × 10−6），特别是在行为调节指数上。较高的平均CD 8活化%与CBCL的外化问题和总问题量表评分较高相关（分别为α β = 0.17，95% CI 0.04-0.31和α β = 0.15，95% CI 0.00-0.28）。感染后的行为结果与较高的病毒载量相关，而较高的CD 8活化与较差的情绪和行为结果相关。对艾滋病毒感染儿童的完整免疫学评估可以包括常用的病毒和免疫学参数，以确定那些具有负面行为结果的风险较高的人，以及谁将从行为干预中获益最多。
HIV can affect the neuropsychological function of children, including their behavior. We aim to identify immunological correlates of behavioral problems among children living with HIV in Uganda. Children participating in a parent randomized control trial in Kayunga, Uganda were assessed with the Behavior Rating Inventory of Executive Function (BRIEF) and the Child Behavior Checklist (CBCL). We constructed simple and multiple linear regression models to identify immunological correlates of behavioral problems. A total of 144 children living with HIV (50% male) with a mean age of 8.9 years [Standard Deviation (s.d.) = 1.9] were included in the analysis. Eighty-two children were on antiretroviral therapy. Mean CD4 cell count % was 35.1 cells/μl (s.d. = 15.0), mean CD4 cell activation 5.7% (s.d. = 5.1), mean CD8 cell activation was 17.5% (s.d. = 11.2) and 60 children (41.7%) had a viral load of <4000 copies/ml. In the adjusted models for the BRIEF, higher scores were associated with higher viral loads (aβ = 16.7 × 10−6, 95% CI −5.00 × 10−6 to 28.4 × 10−6), specifically on the behavioral regulation index. Higher mean CD8 activation % was associated with higher scores on the Externalizing Problems and Total Problems scales of the CBCL (aβ = 0.17, 95% CI 0.04–0.31 and aβ = 0.15, 95% CI 0.00–0.28, respectively). Poorer behavioral outcomes were associated with higher viral loads while higher CD8 activation was associated with poorer emotional and behavioral outcomes. Complete immunological assessments for children living with HIV could include commonly used viral and immunological parameters to identify those at higher risk of having negative behavior outcomes and who would benefit the most from behavioral interventions.