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Cognitive function in young people with and without perinatal HIV in the AALPHI cohort in England: the role of non-HIV related factors

  1. Di M. Gibb1
  2. for the Adolescents and Adults Living with Perinatal HIV (AALPHI) Steering Committee
  1. 1MRC Clinical Trials Unit at University College London, London, UK
  2. 2Imperial College Healthcare NHS Trust, London, UK
  3. 3Imperial College London, London, UK
    1. Corresponding author: Dr Ali Judd, MRC Clinical Trials Unit at UCL, University College London, Aviation House, 125 Kingsway, London WC2B 6NH, Tel: 020 7670 4830, Email: a.judd{at}
    1. * equal contribution status


    Background. There is limited evidence about the cognitive performance of older adolescents with perinatally-acquired HIV (PHIV+) compared to HIV-negative (HIV-) adolescents.

    Methods. 296 PHIV+ aged 12-21 and 97 HIV- aged 13-23 completed 12 tests covering 6 cognitive domains. HIV- adolescents were siblings of PHIV+ and/or had an HIV positive mother. Domain-specific and overall (NPZ-6) z-scores were calculated for PHIV+ with and without CDC class C disease and HIV-. Linear regression explored predictors of NPZ-6.

    Results. 125(42%) PHIV+ and 31(32%) HIV- were male, 251(85%) and 69(71%) were black African, and median age was 16[IQR 15,18] and 16[14,18] years respectively. In PHIV+, 247(86%) were on ART, and 76(26%) had a previous CDC C diagnosis. Mean NPZ-6 scores were -0.81 (standard deviation 0.99) in PHIV+ with a CDC C diagnosis, -0.45 (0.80) in PHIV+ without CDC C, and -0.32 (0.76) in HIV- (p<0.001). After adjustment, there was no difference in NPZ-6 between PHIV+ without a CDC C and HIV- participants (adjusted coefficient -0.01 (95%CI -0.22, 0.20) for PHIV+ no C versus HIV-). PHIV+ with CDC C scored below the HIV- group (adjusted coefficient -0.44 (-0.70, -0.19)). Older age predicted higher NPZ-6 score, whilst black African ethnicity and worse depression predicted lower NPZ-6. In a sensitivity analysis including PHIV+ only, no HIV-related factors apart from CDC C were associated with NPZ-6.

    Conclusions. Cognitive performance was similar among PHIV+ without CDC C diagnoses and HIV-, and indicated relatively mild impairment compared to normative data. The true impact on day-to-day functioning needs further investigation.


    This Article

    1. Clin Infect Dis. doi: 10.1093/cid/ciw568




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