Learning and Memory in Children and Adolescents With Perinatal HIV Infection and Perinatal HIV Exposure.
Learning and Memory in Children and Adolescents With Perinatal HIV Infection and Perinatal HIV Exposure.
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DOI：
10.1097/inf.0000000000001131
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发表时间：
2016-06
期刊：
影响因子：
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通讯作者：
Memory and Executive Functioning Substudy of the Pediatric HIVAIDS Cohort Study
中科院分区：
文献类型：
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作者：
Nichols SL;Chernoff MC;Malee K;Sirois PA;Williams PL;Figueroa V;Woods SP;Memory and Executive Functioning Substudy of the Pediatric HIVAIDS Cohort Study
尽管围产期感染艾滋病毒 (PHIV) 的青少年的学习和记忆对于学业、医疗保健和日常功能很重要，但人们对它们的了解却知之甚少。儿科 HIV/艾滋病队列研究的子研究中，PHIV (n=173) 和围产期 HIV 暴露但未感染 (PHEU, n=85) 参与者（年龄 9-19 岁）完成了言语和视觉学习以及记忆延迟的年龄标准化测试。通过广义估计方程实现的线性回归模型用于比较 PHEU 参与者与有或没有疾病控制和预防中心 (CDC) C 级诊断（PHIV-C，n=45；PHIV-non-C，n=128）的 PHIV 青少年的记忆测量，并根据社会人口统计学协变量进行调整。参与者（平均年龄 = 14.10 岁）中有 54% 是女性，75% 是黑人，18% 是西班牙裔。尽管未经调整的分析显示，与 PHEU 参与者相比，PHIV-C 组的视觉识别记忆和语言延迟回忆显着较低，并且与 PHEU 参与者相比，PHIV-C 组和非 C 组的语言学习水平较低，但在调整社会人口统计学协变量后，仅视觉识别记忆存在差异。对于 PHIV 青少年来说，当前 CD4%<25 与言语学习能力较差相关，而病毒载量峰值年龄较大则与言语延迟回忆和设计记忆能力较差相关。与 PHEU 相比，感染 PHIV 的青少年，尤其是 CDC C 级诊断的青少年，在某些学习和记忆指标上表现较差。尽管言语记忆的群体差异很大程度上归因于社会人口学特征，但 C 类诊断与较差的视觉识别记忆以及当前 CD4% 与较差的言语学习的关联表明 HIV 对感染 PHIV 的青少年的学习和记忆有微妙的影响。
Learning and memory in youth with perinatally acquired HIV (PHIV) are poorly understood despite their importance for academic, healthcare, and daily functioning. PHIV (n=173) and perinatally HIV-exposed but uninfected (PHEU, n=85) participants (age 9–19 years) in a substudy of the Pediatric HIV/AIDS Cohort Study completed age-standardized tests of verbal and visual learning and delayed memory. Linear regression models implemented via generalized estimating equations were used to compare memory measures in PHEU participants versus PHIV youth with and without Centers for Disease Control and Prevention (CDC) Class C diagnosis (PHIV-C, n=45; PHIV-non-C, n=128, respectively), adjusting for sociodemographic covariates. Participants (mean age=14.10 years) were 54% female, 75% Black, and 18% Hispanic. Although unadjusted analyses showed significantly lower visual recognition memory and verbal delayed recall for PHIV-C compared to PHEU participants and lower verbal learning for PHIV-C and non-C groups compared to PHEU, differences persisted only for visual recognition memory after adjusting for sociodemographic covariates. For PHIV youth, current CD4%<25 was associated with poorer verbal learning, and older age at peak viral load was associated with poorer verbal delayed recall and design memory. Youth with PHIV, particularly those with CDC Class C diagnosis, showed poorer performance on some measures of learning and memory compared to PHEU. Although group differences in verbal memory were largely attributable to sociodemographic characteristics, associations of Class C diagnosis with poorer visual recognition memory and of current CD4% with poorer verbal learning suggest subtle effects of HIV on learning and memory in youth with PHIV.