Early neurodevelopmental growth in children with vertically transmitted human immunodeficiency virus infection

C. Chase, M. Vibbert, S. I. Pelton, D. L. Coulter and H. Cabral
Department of Pediatrics, University School of Medicine, Boston City Hospital, Mass., USA.

OBJECTIVE: To examine mental and motor development in children with vertically transmitted human immunodeficiency virus (HIV) infection in the first 30 months of life. DESIGN: Prospective longitudinal study comparing two groups: children with HIV infection and HIV-exposed but uninfected children. SETTING: Pediatric Immunodeficiency Clinic at Boston (Mass) City Hospital, Boston University Medical Center. STUDY PARTICIPANTS: Twenty-four children with vertically transmitted HIV infection and 27 children who were born to HIV-infected mothers and became HIV negative served as controls. Socioeconomic status, gestational age, and prenatal drug exposure were comparable in the two groups. MEASUREMENTS/RESULTS: Using the Bayley Scales of Infant Development, all children were assessed at least once between 4 and 16 months and again between 17 and 30 months of age. Individual mean mental and motor scores were calculated for the early and later age span. Motor development in the infected group was delayed in comparison to the seroreverter group in both age spans and remained stable in both groups over time. Mental development was comparable in the two groups at 4 to 17 months, but HIV infection was associated with delay in mental development at 17 to 30 months of age. CONCLUSION: Early and persistent delay in motor development and deceleration in mental development in late infancy distinguishes many children who are HIV infected from exposed but uninfected children, but there is significant variability in early neurodevelopmental outcome among children with HIV infection.

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