Background

Assessing the role of HIV and non-HIV related factors is essential for a better understanding of the neurocognitive outcomes in perinatally HIV-infected (PHIV+) young people. The aim of our study was to assess cognition and quality of life (QoL) of a PHIV+ cohort of young people and to compare it with a control group.

Methods

Thirty PHIV+ and 30 HIV(−) healthy young adults matched by age, sex and socioeconomic status completed a protocol that included neurocognitive tests, a psychosocial semi-structured interview and a QoL questionnaire (PedsQL). Neurocognitive domain-specific and domain-general (NPZ-5) Z-scores were calculated. CDC AIDS-defining category C or not C (PHIV+/C, PHIV+/noC) was considered to evaluate differences within the PHIV+ group. Univariate and multivariate analysis were performed.

Results

Sixty patients were included; 67% were female; median age (IQR) 19 years (18–21). Regarding PHIV+ young people, 27% showed CDC C category (none encephalopathy), 93% were on ART and 77% had undetectable viral load. No differences regarding occupation were found, although the HIV(−) group repeated less grades (p = 0.028) and had a higher education level (p = 0.021).

No differences were found between PHIV+/noC and HIV(−) participants. However, the PHIV+/C group showed poorer performance than PHIV+/noC (NPZ-5, p = 0.037) and HIV(−) subjects (crystallised intelligence, p = 0.025; intelligence quotient, p = 0.016). Higher nadir CD4+ T-cell count was related to better Z-score in memory (p = 0.007) and NPZ-5 (p = 0.025). Earlier and longer exposure to ART resulted in better performance in memory (p = 0.004) and executive functions (p = 0.015), respectively.

Conclusions

No significant differences were found in the neurocognitive profile nor QoL between PHIV+/noC and HIV(−) adolescents; however, PHIV+/C participants obtained lower scores. The use of longer and earlier ART seems to have a beneficial effect.

中文翻译：

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围产期感染 HIV 的年轻人及其同龄人的神经认知和生活质量研究。NeuroCoRISpeS 研究。

背景

评估 HIV 和非 HIV 相关因素的作用对于更好地了解围产期 HIV 感染 (PHIV+) 年轻人的神经认知结果至关重要。我们研究的目的是评估 PHIV+ 年轻人群体的认知和生活质量 (QoL)，并将其与对照组进行比较。

方法

按年龄、性别和社会经济地位匹配的 30 名 PHIV+ 和 30 名 HIV(-) 健康年轻人完成了一项协议，其中包括神经认知测试、心理社会半结构化访谈和 QoL 问卷 (PedsQL)。计算神经认知域特异性和域一般 (NPZ-5) Z分数。CDC AIDS 定义类别 C 或非 C（PHIV+/C、PHIV+/noC）被认为是评估 PHIV+ 组内的差异。进行了单变量和多变量分析。

结果

包括 60 名患者；67% 是女性；中位年龄 (IQR) 19 岁 (18-21)。关于 PHIV+ 的年轻人，27% 显示为 CDC C 类别（无脑病），93% 接受 ART，77% 的病毒载量无法检测到。尽管 HIV(-) 组的重复成绩较低 ( p  = 0.028) 且受教育程度较高 ( p  = 0.021)，但未发现职业差异。

在 PHIV+/noC 和 HIV(-) 参与者之间没有发现差异。然而，PHIV+/C 组的表现比 PHIV+/noC（NPZ-5，p  = 0.037）和 HIV（-）受试者（结晶智力，p  = 0.025；智商，p  = 0.016）差。较高的最低点 CD4+ T 细胞计数与更好的记忆Z值 ( p  = 0.007) 和 NPZ-5 ( p  = 0.025) 相关。更早和更长时间接触 ART 分别导致更好的记忆 ( p  = 0.004) 和执行功能 ( p  = 0.015) 表现。

结论

PHIV+/noC 和 HIV(-) 青少年之间的神经认知特征和 QoL 均未发现显着差异；然而，PHIV+/C 参与者的得分较低。使用更长时间和更早的 ART 似乎有好处。