In utero antiretroviral exposure and sociodemographic characteristics on neurodevelopment of HIV‐exposed uninfected children versus HIV‐unexposed uninfected healthy children in Malawi. Issue 3 (31st December 2020)

• Record Type: Journal Article
• Authors: Zhang, Xiaohua; Wang, Lirong; Han, Jucai; Xie, Li; Wu, Ning; Nyirenda, Rose; Shumba, Khumbo; Simwanza, Winson; Kulyk, Oleksandr; Chilapondwa, Verydear; Li, Xu
• Is Part Of: International journal of gynaecology and obstetrics. Volume 153:Issue 3(2021)
• Page Start: 424
• Page End: 437
• Publication Date: 2020-12-31
• Subjects: Bayley‐II -- HIV‐exposed uninfected children -- HIV‐unexposed uninfected children -- in utero antiretroviral treatment -- mental development index -- option B+ -- psychomotor development index; Gynecology -- Periodicals; Obstetrics -- Periodicals; Electronic journals; 618
• DOI: 10.1002/ijgo.13511
• Languages: English
• ISSNs: 0020-7292

Abstract

Abstract: Background: To evaluate mental development index (MDI) and psychomotor development index (PDI) scores of HIV‐exposed uninfected (HEU) children by timing of in utero antiretroviral treatment (ART) initiation (Option B+) and sociodemographic characteristics compared with HIV‐unexposed uninfected (HUU) children in Mzuzu, Malawi. Methods: One hundred HEU children and 100 HUU children aged 2–30 months were recruited. The differences in MDI and PDI scores between HEU and HUU children were tested by Student's t test, analysis of variance, Mann–Whitney U test, and logistic regression analysis. Results: The differences in MDI and PDI scores might be related to number of children in the family, delivery, place of residence, family income, complementary feeding, father's or mother's occupation, and degree of education. No significant difference in MDI and PDI scores between HEU and HUU children ( P = 0.076 and P = 0.407) was found. Among HEU children, ART in the third trimester and beyond produced a lower PDI score compared with ART before pregnancy and in the first or second trimester ( P = 0.027). Conclusion: The MDI and PDI scores of HEU subgroups with different timing of ART (Option B+) initiation were comparable to those of the HUU group. Early in utero ART initiation was associated with better neurodevelopmental outcomes than ART initiation in the third trimester and beyond. Synopsis: Our findings showed that early in utero ART initiation was associated with better neurodevelopmental outcomes than ART initiation in third trimester and beyond.