Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Feb;141(2):e20172888.
doi: 10.1542/peds.2017-2888.

Neurodevelopment in Young Children Born to HIV-Infected Mothers: A Meta-analysis

Megan S McHenry  1   2 , Carole I McAteer  3   2 , Eren Oyungu  4 , Brenna C McDonald  5 , Chris B Bosma  3 , Philani B Mpofu  6 , Andrew R Deathe  3 , Rachel C Vreeman  3   2   4
Affiliations
Meta-Analysis

Neurodevelopment in Young Children Born to HIV-Infected Mothers: A Meta-analysis

Megan S McHenry et al. Pediatrics. 2018 Feb.

Abstract

Context: HIV-infected (HIV+) children have worse neurodevelopmental outcomes compared with HIV-uninfected children. However, little is known regarding the differences in neurodevelopment between young HIV+ children, HIV-exposed but uninfected (HEU) children, and HIV-unexposed and uninfected (HUU) children.

Objective: To systematically review and meta-analyze data on neurodevelopmental performance between young HIV+, HEU, and HUU children.

Data sources: We systematically searched the following electronic bibliographic databases: Ovid Medline, Embase, PsycINFO, Education Resources Information Center, and the Cochrane Database of Systematic Reviews.

Study selection: Studies were selected on the basis of defined inclusion criteria. Titles, abstracts, and full texts were assessed by 2 independent reviewers.

Data extraction: Data were extracted by 2 independent reviewers and cross-checked by 2 additional reviewers.

Results: Forty-five studies were identified for inclusion in the systematic review, and of these, 11 were included in the meta-analysis on the basis of availability of Bayley Scales of Infant and Toddler Development scores. Within the meta-analysis, when compared with their HUU peers, HIV+ and HEU children had lower cognitive and motor scores. HIV+ and HEU children with antiretroviral (ARV) exposure had lower cognitive and motor scores compared with those without ARV exposure.

Limitations: We were unable to control adequately for intravenous drug use, geographic location, or quality of the assessment independently.

Conclusions: Both HIV+ and HEU children had worse developmental outcomes compared with HUU children. HIV+ and HEU children with ARV exposure also had worse developmental outcomes compared with those without exposure; however, these results should be interpreted with caution. More research is needed to identify the impact of ARV exposure on young children.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. ERIC, Education Resources Information Center.
FIGURE 2
FIGURE 2
Study cohort–specific differences in mean BSID scores by subtest and comparison of HIV exposure groups. The size of the box representing the point estimate of the mean is proportional to the inverse square of the SE. The second group in each comparison had the larger mean BSID score. A, MDI. B, PDI.
FIGURE 3
FIGURE 3
Summarized Bayesian estimates of mean scores and 95% credible intervals relative to the HIV-unexposed group by HIV exposure group and BSID subtest. A, MDI. B, PDI.
FIGURE 4
FIGURE 4
Comparison of high- versus low-quality assessments by HIV exposure group and BSID subtest. A, MDI. B, PDI. CI, confidence interval; MD, mean difference.
FIGURE 5
FIGURE 5
Comparison of ARV medication exposure versus none by HIV exposure group and BSID subtest. A, MDI. B, PDI. CI, confidence interval; MD, mean difference.
See this image and copyright information in PMC

References

    1. Abubakar A, Van Baar A, Van de Vijver FJ, Holding P, Newton CR. Paediatric HIV and neurodevelopment in sub-Saharan Africa: a systematic review. Trop Med Int Health. 2008;13(7):880–887 - PubMed
    1. Phillips N, Amos T, Kuo C, et al. . HIV-associated cognitive impairment in perinatally infected children: a meta-analysis. Pediatrics. 2016;138(5):e20160893. - PMC - PubMed
    1. Sherr L, Croome N, Parra Castaneda K, Bradshaw K, Romero RH. Developmental challenges in HIV infected children—an updated systematic review. Child Youth Serv Rev. 2014;45:74–89
    1. Filteau S. The HIV-exposed, uninfected African child. Trop Med Int Health. 2009;14(3):276–287 - PubMed
    1. Powis KM, Slogrove AL, Mofenson L. Protecting the health of our AIDS-free generation: beyond prevention of mother-to-child HIV transmission. AIDS. 2017;31(2):315–316 - PMC - PubMed

Publication types