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Memory Functioning in Children and Adolescents with Perinatal HIV Infection

围产期艾滋病毒感染儿童和青少年的记忆功能

基本信息

批准号：
8197402
负责人：
SHARON L NICHOLS
金额：
$ 41.08万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-18 至 2014-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8197402
关键词：
AIDS neuropathy AIDS/HIV problem Academic achievement Adaptive Behaviors Adherence Adolescence Adolescent Adult Affect Age Anti-Retroviral Agents Area Attention Behavior Behavioral Birth Brain Caregivers Caring Centers for Disease Control and Prevention (U.S.)Child Childhood Chronic Disease Clinical Sciences Cognitive Cohort Studies Communities Complex Data Development Diagnosis Disease Disease Marker Failure Future Generations Goals HIV HIV Infections HIV-1 Health Healthcare Impairment Infection Intention Intervention Investigation Knowledge Language Learning Life Literature Longevity Longitudinal Studies Measures Medical Medication Management Memory Mosses Neuraxis Neurocognitive Occupational Outcome Parents Pattern Performance Perinatal Perinatal Infection Persons Pharmaceutical Preparations Population Problem Solving Protocols documentation Provider Public Health Quality of life Reading Recording of previous events Relative (related person)Research Research Design Resistance Resources Risk Sampling Self Care Severities Severity of illness Short-Term Memory Site Task Performances Testing Time Underserved Population Viral Virus Youth advanced disease base coping cost effective daily functioning design economic implication effective intervention executive function falls flexibility functional outcomes health economics improved functioning insight longitudinal design medication compliance meetings neuropathology pediatric human immunodeficiency virus infection peer physical conditioning prospective memory skills social social skills therapy development tool young adult

项目摘要

DESCRIPTION (provided by applicant): Current treatments have transformed HIV/AIDS from an inevitably fatal disease to one commonly managed as a chronic illness. Many children born with HIV infection, who previously suffered brief life spans, are now surviving into adulthood. This creates the need to understand more fully the obstacles these youth encounter in becoming independent, productive adults. In adults, HIV commonly is associated with impairments in memory and executive functions (such as inhibition, cognitive flexibility, and problem solving), which increase the risk of problems in day-to-day functioning, including medication nonadherence. Studies of memory and executive functions in children and youth with HIV infection are extremely limited, however, and none have included measures of prospective memory (that is, the ability to execute a future intention), which is a particularly robust predictor of daily functioning in adults with HIV. Furthermore, our current understanding of the functional impact of HIV on brain development is limited. The study proposed here would be the first to evaluate the complex interplay between development and HIV infection on memory and executive functions in the context of important functional outcomes in an effort to advance the clinical science of pediatric neuroAIDS. The study will test the hypotheses that: 1) perinatally acquired HIV is associated with deficits in memory and executive functioning; 2) HIV severity and history, including age at greatest disease severity, will be associated with degree of impairment in memory and executive functioning ; 3) developmental change and changes in HIV severity will interact to influence these functions over time; and 4) impairments in memory and executive function contribute to problems in daily functioning (including medication adherence, academic achievement, and adaptive behavior). Using a longitudinal design to examine and control for developmental changes in these functions during adolescence, we will administer measures of verbal and nonverbal retrospective memory, prospective memory, executive functions, and medication adherence to 200 HIV-infected and 75 uninfected youth age 9-18 at two time points, two years apart. Data will be collected at eight sites participating in a large national, longitudinal study of outcomes of perinatal HIV infection, the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol, thus allowing us to examine memory and executive functioning in an efficient and cost-effective manner in the larger context of demographic, health-related, cognitive, and behavioral aspects of perinatal HIV infection. This is an important area for investigation because deficits in memory and executive function in youth with HIV could have wide-ranging effects on their acquisition of health and medication management skills, adaptive and academic functioning, behavior, and, ultimately, social and occupational outcome in adulthood. We anticipate this study will not only elucidate developmental neurocognitive aspects of perinatally acquired HIV but will also provide important information and additional tools to target areas of intervention for perinatally HIV-infected youth at risk for poor functional outcomes.