Format

Send to

Choose Destination
J Pediatric Infect Dis Soc. 2016 Dec;5(suppl 1):S33-S40.

Longitudinal Evaluation of Language Impairment in Youth With Perinatally Acquired Human Immunodeficiency Virus (HIV) and Youth With Perinatal HIV Exposure.

Author information

1
Communication Sciences and Disorders, University of Utah.
2
Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health.
3
Child Language Program, University of Kansas.
4
Epidemiology and Statistics Program, National Institute on Deafness and Other Communication Disorders, National Institutes of Health.
5
Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health.
6
Maternal, Child and Adolescent Center for Infectious Diseases and Virology, Keck School of Medicine of the University of Southern California.
7
Division of Pediatric Infectious Disease, Department of Pediatrics, Bronx-Lebanon Hospital Center, New York, New York.

Abstract

BACKGROUND:

Language impairment (LI) risk is increased for perinatally acquired human immunodeficiency virus-infected (PHIV) and perinatally exposed to HIV but uninfected (PHEU) youth. This study evaluates the persistence of LI in these groups.

METHODS:

The Clinical Evaluation of Language Fundamentals was repeated on participants of the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol 18 months postbaseline. Regression models identified factors associated with change in standardized score (SC) and the resolution or development of LI.

RESULTS:

Of 319 participants, 112 had LI at baseline. Upon re-evaluation, SCs were highly stable and changes were similar in PHIV (n = 212) and PHEU (n = 107) participants. Those with family history of language delays had a 2.39 point lower mean increase in SCs than those without, after controlling for demographic and socioeconomic factors and baseline LI status. Among PHIV participants, CD4 count <350 cells/mm3 was associated with lower mean SC change (4.32 points), and exposure to combination antiretroviral therapy (cART) or protease inhibitors (PIs) was associated with a higher mean SC change (5.93 and 4.19 points, respectively). Initial LI was persistent in most cases (78%); 20 new cases occurred (10%). Female sex was associated with higher odds of LI resolution. Among PHIV, duration and baseline cART and history of PI use were associated with LI resolution; higher percentage of detectable viral loads before baseline was associated with lower odds of resolution.

CONCLUSIONS:

The PHIV and PHEU youth are at risk for persistent LI, and family history of language delays was a risk factor for persistence of problems. Measures of successful HIV treatment predicted more favorable outcomes among PHIV youth.

KEYWORDS:

antiretroviral therapy; language development; language impairment; perinatal HIV; youth

PMID:
27856674
PMCID:
PMC5181542
DOI:
10.1093/jpids/piw045
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center