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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Cognitive and language outcomes in HIV-uninfected infants exposed to combined antiretroviral therapy in utero and through extended breast-feeding
AIDS, Volume 28, No. SUPPL. 3, Year 2014
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Description
OBJECTIVE:: To determine whether there is a higher risk for cognitive or language delay among HIV-exposed uninfected (HEU) children exposed to cART (zidovudine/lamivudine/lopinavir/ritonavir) in utero and through 1 year of breast-feeding (World health Organization Option B+), compared with the control children born to HIV-uninfected mothers. DESIGN:: This is a double cohort study from Lusaka, Zambia. METHODS:: HEU (n = 97) and control (n = 103) children aged 15-36 months were assessed on their early nonverbal problem-solving and language skills using the standardized Capute Scales. A score of less than 85 on the Capute Full-Scale Developmental Quotient (FSDQ) was considered indicative of developmental delay and was the primary outcome of interest. RESULTS:: An FSDQ of less than 85 was found in eight (8.3%) of HEU participants and 15 (14.6%) of controls. In univariate logistic regressions, lower income [odds ratio (OR) = 0.93, P = 0.02], older infant age (OR = 1.08, P = 0.03), lower birth weight (OR = 0.16, P < 0.001), and less maternal education (OR = 0.41, P = 0.047) were associated with the probability of FSDQ less than 85, whereas Group (control/HEU) was not (OR = 1.88, P = 0.16). In the multivariable analysis, only lower birth weight (OR = 0.15, P < 0.001) remained associated with FSDQ less than 85. CONCLUSIONS:: Our study did not support the presence of an adverse effect on cognitive and language development with prolonged antepartum and postpartum cART e/xposure. Larger studies and studies of older HEU children will be required to confirm these reassuring findings. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Ngoma, Mary Shilalukey
Zambia, Lusaka
University of Zambia School of Medicine
Zambia, Lusaka
University Teaching Hospital Lusaka
Hunter, Jennifer A.
Canada, Toronto
University of Toronto
Harper, Jessica A.
Canada, Toronto
University of Toronto
Church, Paige Terrien
Canada, Toronto
University of Toronto
Mumba, Scholastica
Zambia, Lusaka
University Teaching Hospital Lusaka
Chandwe, Mulapati
Zambia, Lusaka
University Teaching Hospital Lusaka
Côté, Hélène C.F.
Canada, Vancouver
The University of British Columbia
United States, Amarillo
Women's Health Research Institute
Albert, Arianne Y.K.
United States, Amarillo
Women's Health Research Institute
Smith, Mary Lou
Canada, Toronto
University of Toronto
Canada, Toronto
Hospital for Sick Children University of Toronto
Selemani, Chisomo
Zambia, Lusaka
University of Zambia School of Medicine
Sandstrom, P.
Canada, Ottawa
Public Health Agency of Canada
Bandenduck, Lucas
Canada, Toronto
University of Toronto
Ndlovu, Utsile
Canada, Toronto
University of Toronto
Khan, Sara
Canada, Toronto
University of Toronto
Roa, Lina
Canada, Toronto
University of Toronto
Silverman, Michael S.
Canada, Toronto
University of Toronto
Canada, London
Western University
Statistics
Citations: 16
Authors: 16
Affiliations: 8
Identifiers
Doi:
10.1097/QAD.0000000000000357
e-ISSN:
14735571
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Case-Control Study
Study Approach
Quantitative
Study Locations
Zambia