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J Dev Behav Pediatr. 2012 Feb;33(2):112-23. doi: 10.1097/DBP.0b013e318241ed23.

Language impairment in children perinatally infected with HIV compared to children who were HIV-exposed and uninfected.

Author information

1
Department of Speech, Language, Hearing, University of Kansas, Lawrence, KS 66045, USA. mabel@ku.edu

Abstract

OBJECTIVE:

To investigate the risk for language impairment (LI) in children perinatally infected or exposed to HIV.

METHODS:

We evaluated the prevalence of LI in 7- to 16-year-old children with perinatal HIV infection (HIV+) compared with HIV-exposed and uninfected children, using a comprehensive standardized language test (Clinical Evaluation of Language Functioning-Fourth Edition [CELF-4]). LI was classified as primary LI (Pri-LI) (monolingual English exposure and no cognitive or hearing impairment), concurrent LI (Con-LI) (cognitive or hearing impairment), or no LI. Associations of demographic, caregiver, HIV disease, and antiretroviral treatment factors with LI category were evaluated using univariate and multivariable logistic regression models.

RESULTS:

Of the 468 children with language assessments, 184 (39%) had LI. No difference was observed by HIV infection status for overall LI or for Pri-LI or Con-LI; mean (SD) CELF-4 scores were 88.5 (18.4) for HIV+ versus 87.5 (17.9) for HIV-exposed and uninfected children. After adjustment, black children had higher odds of Pri-LI versus no LI (adjusted odds ratio [aOR] = 2.43, p = .03). Children who were black, Hispanic, had a caregiver with low education or low intelligence quotient, or a nonbiological parent as caregiver had higher odds of Con-LI versus no LI. Among HIV+ children, viral load >400 copies/mL (aOR = 3.04, p < .001), Centers for Disease Control and Prevention Class C (aOR = 2.19, p = .02), and antiretroviral treatment initiation <6 months of age (aOR = 2.12, p = .02) were associated with higher odds of Con-LI versus no LI.

CONCLUSIONS:

Children perinatally exposed to HIV are at high risk for LI, but such risk was not increased for youth with HIV. Risk factors differed for Pri-LI and Con-LI.

PMID:
22179050
PMCID:
PMC3310927
DOI:
10.1097/DBP.0b013e318241ed23
[Indexed for MEDLINE]
Free PMC Article

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