Cognitive assessment of human immunodeficiency virus-exposed children
R. L. Levenson Jr, C. A. Mellins, R. Zawadzki, R. Kairam and Z. Stein
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, New York.
OBJECTIVE--To determine (1) the level of impairment in cognitive and motor
functioning in human immunodeficiency virus (HIV)-exposed and HIV-infected
preschool and school-age children; (2) cognitive strengths and weaknesses
that characterize HIV-infected children; and (3) potential contributions of
serostatus, neurologic impairment, and prenatal drug-exposure to cognitive
functioning. DESIGN--Cross-sectional, single-blind study.
SETTING--Pediatric neurology clinic at a large metropolitan hospital in New
York, NY. PARTICIPANTS--Forty-one HIV-infected and eight seroreverter
school-age children. INTERVENTIONS--The McCarthy Scales of Children's
Abilities were administered to all children, as was the Neurologic
Examination for Children. MEASUREMENTS/MAIN RESULTS--The obtained mean of
the sample on the McCarthy Scales' General Cognitive Index was in the
Borderline range, with 44% of the subjects scoring in the Mentally Retarded
range. The most severe cognitive deficits were found on the Quantitative,
Verbal, and Memory scales (Borderline range). Children infected with HIV
with neurologic impairment performed significantly worse than did
seroverters and neurologically normal HIV-infected children. There were no
significant differences in cognitive functioning due to gender, ethnicity,
and prenatal drug exposure. CONCLUSIONS--Cognitive deficits were detected
in HIV-infected and seroreverted children. The presence of neurologic
dysfunction in HIV-infected children markedly intensified these deficits.
