HIV-positive children face increased risks for neurological development impairments

In a significant development, a long-term collaboration between the University of Rochester Medical Center (URMC) and the University Teaching Hospital in Lusaka, Zambia, has yielded new insights into the neurological challenges faced by children living with HIV. This research, spearheaded by neurologist Gretchen Birbeck, M.D., and her international research group, the Tropical Neurology Group, since 1994, has been instrumental in this discovery.

The study, published in the Journal of Acquired Immune Deficiency Syndromes, is part of the ongoing HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) study. This longitudinal study, which follows a cohort of 600 HIV positive and negative Zambian children ages 8 to 18 for 5 years, has shed light on the cognitive and mental health issues that persist in HIV-infected children, despite widespread accessibility to combination antiretroviral therapy (cART).

David Bearden, M.D., an assistant professor of Neurology and Pediatrics at URMC and the senior author of the study, explains that early detection and treatment of HIV with antiretroviral therapy (cART) may improve cognitive outcomes in children. However, the research indicates that many HIV-infected children in sub-Saharan Africa still experience associated neurocognitive and psychiatric deficits, such as delayed academic development and depression.

In the HANDZ study, HIV positive children on cART performed significantly worse on cognitive measures at baseline and did not improve over the two-year study period, compared to their HIV negative peers. Malnutrition and severe HIV infection were associated with worse performance on the neurocognitive assessments.

The study received support from the University of Zambia and the University Teaching Hospital, Lusaka, as well as funding from the National Institute of Neurological Disorders and Stroke, the University of Rochester Center for AIDS Research, and the University of Rochester School of Medicine.

The Neurology Research Office established by Birbeck on the main hospital campus now serves as a hub for several National Institutes of Health-funded research and training programs. This office at the URMC continues to be a beacon of research and innovation in the field of neurology.

The HANDZ study used the NIH Toolbox Cognition Battery to assess cognitive processes in HIV positive and negative Zambian children. The study findings emphasize the importance of early detection and treatment of HIV, as well as addressing nutritional needs, to improve cognitive outcomes in children.

The research team includes Gauri Patil, Hannah Smith, Alexandra Buta, Heather Adams, Michael Potchen, Brent Johnson, Giovanni Schifitto, Handy Gelbard, Esau Mbewe, Pelekelo Kabundula, and Milimo Mweemba, in addition to Bearden and Birbeck.

HIV remains a major global health burden, particularly in sub-Saharan Africa, where it accounts for approximately 70 percent of global cases. The findings from this study underscore the need for continued research and intervention to address the cognitive and mental health issues faced by HIV-infected children in this region.

HIV-positive children face increased risks for neurological development impairments