Neurodevelopment at 11 months after starting antiretroviral therapy within 3 weeks of life
Southern African Journal of HIV Medicine
| Field | Value | |
| Title | Neurodevelopment at 11 months after starting antiretroviral therapy within 3 weeks of life | |
| Creator | Laughton, Barbara Naidoo, Shalena Dobbels, Els F.M.T. Boivin, Michael J. Janse van Rensburg, Anita Glashoff, Richard H. van Zyl, Gert U. Kruger, Mariana Cotton, Mark F. | |
| Description | Background: Antiretroviral therapy (ART) started between 7 and 12 weeks of age improves neurodevelopmental outcomes in HIV-infected (HIV+) infants, but the impact of even earlier initiation is not yet described.Objective: We assessed the early neurodevelopment of HIV+ infants who started ART within 21 days of life. Methods: Participants were enrolled from the public sector birth HIV-diagnosis program. Inclusion criteria included: birth weight 2000g, infant commencing ART 6 weeks and no infant Cytomegalovirus disease. ART included Zidovudine/Lamivudine/Nevirapine for the first 2 weeks, the latter then replaced by Lopinavir/Ritonavir. Once body weight 3kg and gestational age 44 weeks, Abacavir replaced Zidovudine. The Griffiths Mental Development Scales (GMDS) were administered at 10-12 months.Results: Of 29 infants assessed, 23 (79%) were girls. Mean birth weight was 3002 ± 501g. Twenty-four mothers (83%) received ART during pregnancy. Seven (24%) infants were diagnosed HIV+ within 48 hours of birth. Median [IQR] viral load (VL) at diagnosis was 3904 [259;16922] copies/ml, age starting ART was 6.0 [3;10] days and age at VL suppression was 19.1 [15; 36] weeks. At the GMDS assessment nine (31%) participants had detectable VL and 26 (90%) had WHO clinical stage I disease. GMDS was performed at a mean age of 11.5±0.8 months. Mean quotients were within the average range: Global Griffiths score was 103.6±10.9 and mean quotients on the subscales ranged from lowest 95.9±13.4 for Locomotor to highest 112.8±11.3 for Hearing-and-language.Conclusion: Preliminary findings in this small group suggest that early neurodevelopmental scores are within the normal range in infants with perinatal HIV-infection who started ART at a median of 6 days. | |
| Publisher | AOSIS | |
| Date | 2019-10-30 | |
| Identifier | 10.4102/sajhivmed.v20i1.1008 | |
| Source | Southern African Journal of HIV Medicine; Vol 20, No 1 (2019); 8 pages 2078-6751 1608-9693 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://sajhivmed.org.za/index.php/hivmed/article/view/1008/1693
https://sajhivmed.org.za/index.php/hivmed/article/view/1008/1692
https://sajhivmed.org.za/index.php/hivmed/article/view/1008/1694
https://sajhivmed.org.za/index.php/hivmed/article/view/1008/1691
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