Wednesday, December 25, 2019

HIV affects young brains even after early treatment

A new study has given a clear understanding about how even with early treatment, HIV still manages to attack young brains.

Across sub-Saharan Africa today, a vast majority of children suffer from HIV. While early antiretroviral treatment, or ART, ensured that children with and exposed to HIV have less deadly results, studies have shown that the virus can still affect the brain.


HIV may disrupt neuro-development, affecting how children learn, reason and function.


This is why, researcher gave a two-year longitudinal study to obtain a clear picture of how HIV influences children's neuro-psychological growth.


The neuro-psychological performance in 3 groups of children 5-11 years old has been examined by the researchers- individuals who acquire HIV perinatally and were treated with ART, those exposed but HIV-negative, and those who were never exposed.


The study was carried out at 6 testing sites in 3 Sub-Saharan African countries to look robustly at how HIV affects children in this field.


To date, it's the 1st well-validated, multi-site neuro-psychological evaluation of African school-aged children affected by HIV.


The researchers found that there are still major neuro-psychological challenges for children living with HIV even in the face of early treatment and good clinical care.


One of the researchers said- these children came into the study with a deficit compared to their counterparts. It stayed about the same throughout the 2 years, except in one important area- reasoning and planning. On that specific test domain, the children living with HIV failed to progress over time.
In other words, in the field of planning and thinking over the course of the study, the difference between infected and HIV-negative children increased.


Such skills typically develop in healthy children in the school years.


This is the most important cognitive function for the future of children living with HIV in terms of their likelihood of taking their medications, making good decision, abstaining from risky behaviours like early sexual activity, psycho-social issues and school-related achievement, he said.


However, early medical treatment started as early as 6 months of age, is probably not enough to address the neurocognitive deficits associated with HIV, even though it helps keep children alive and healthier than they would be without treatment.


In these children, treatment should be started even earlier to improve long-term neurocognitive outcomes.


Researchers are already working on long-term care and support. Earlier this year, the head researcher received a 50year, 3.2 million $ NIH grant to continue his work with children affected by HIV un Uganda and Malawi.


Through this grant, researchers will investigate how MSU-developed computer cognitive games can serve as tools for neurocognitive evaluation, enrichment and potentially rehabilitation.


He hopes that the findings of the 2 experiments will contribute to making this neuro-psychological evaluation paradigm part of the cost-benefit of caring for HIV-affected children.


Often it's overlooked or seen as an afterthought, but unlike other areas of medical follow-up neuro-psychological evaluation really gets at how well the kids are going to adapt and function in school, at home, in the community and in society in general, he said. It's really what links us most directly to the human burden of disease.


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