Neurocognitive function among HIV-infected children on protease inhibitor -based versus non-protease inhibitor based antiretroviral therapy in Uganda: a pilot study. 2021

Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, P. O. Box 7072, Kampala, Uganda. damalielwanga@gmail.com.

HIV infection is associated with significant neurocognitive deficits making maximization of cognitive function among children receiving antiretroviral therapy (ART) a public health imperative. Non-protease inhibitors (non-PIs) achieve higher drug levels in the cerebral spinal fluid (CSF) compared to PIs, potentially leading to better neurocognitive function by reducing CSF viral load and inflammation. ART that maximises children's neurodevelopment and school achievement could result in improved quality of life and productivity as adults, but little research to date has examined whether non-PI ART is associated with better neurocognitive outcomes. We compared the neurocognitive function between children living with HIV receiving PI-based and non PI-based ART. We recruited a consecutive sample of clinically stable Ugandan children living with HIV aged 5-12 years who received PI-based or non PI-based ART for ≥ 1 year (viral load < 1000 copies). Neurocognitive function was assessed using the Kaufman Assessment Battery for Children, the Test of Variables of Attention, and Bruininks-Oseretsky Test of Motor Proficiency. Age-adjusted neurocognitive z-scores for the two groups were compared using linear regression models in STATA version 13. The Hommel's method was used to adjust for multiple testing. We enrolled 76 children living with HIV; 34 on PI ART and 42 on non-PI ART. Mean (±SD) age was greater in the non-PI vs. PI group (9.5 ± 1.9 vs. 8.5 ± 2.0) years (p = 0.03). Children in the non-PI group had lower socioeconomic scores (5.7 ± 3.3 vs. 7.4 ± 2.8, p = 0.02). There was no difference in neurocognitive function between the groups (adjusted p > 0.05) for KABC and TOVA. Children in the PI group had better total BOT scores than their counterparts (46.07 ± 1.40) vs. 40.51 (1.24), p = 0.03). We detected no difference in neurocognitive function among children on PI and non PI-based ART therapy based on KABC and TOVA tests. Children on PI based ART had better motor function than their counterparts. We recommend a prospective study with a larger sample size.

UI MeSH Term Description Entries
D010865 Pilot Projects Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work. Pilot Studies,Pilot Study,Pilot Project,Project, Pilot,Projects, Pilot,Studies, Pilot,Study, Pilot
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011480 Protease Inhibitors Compounds which inhibit or antagonize biosynthesis or actions of proteases (ENDOPEPTIDASES). Antiprotease,Endopeptidase Inhibitor,Endopeptidase Inhibitors,Peptidase Inhibitor,Peptidase Inhibitors,Peptide Hydrolase Inhibitor,Peptide Hydrolase Inhibitors,Peptide Peptidohydrolase Inhibitor,Peptide Peptidohydrolase Inhibitors,Protease Antagonist,Protease Antagonists,Antiproteases,Protease Inhibitor,Antagonist, Protease,Antagonists, Protease,Hydrolase Inhibitor, Peptide,Hydrolase Inhibitors, Peptide,Inhibitor, Endopeptidase,Inhibitor, Peptidase,Inhibitor, Peptide Hydrolase,Inhibitor, Peptide Peptidohydrolase,Inhibitor, Protease,Inhibitors, Endopeptidase,Inhibitors, Peptidase,Inhibitors, Peptide Hydrolase,Inhibitors, Peptide Peptidohydrolase,Inhibitors, Protease,Peptidohydrolase Inhibitor, Peptide,Peptidohydrolase Inhibitors, Peptide
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014454 Uganda A republic in eastern Africa, south of SUDAN and west of KENYA. Its capital is Kampala. Republic of Uganda
D015658 HIV Infections Includes the spectrum of human immunodeficiency virus infections that range from asymptomatic seropositivity, thru AIDS-related complex (ARC), to acquired immunodeficiency syndrome (AIDS). HTLV-III Infections,HTLV-III-LAV Infections,T-Lymphotropic Virus Type III Infections, Human,HIV Coinfection,Coinfection, HIV,Coinfections, HIV,HIV Coinfections,HIV Infection,HTLV III Infections,HTLV III LAV Infections,HTLV-III Infection,HTLV-III-LAV Infection,Infection, HIV,Infection, HTLV-III,Infection, HTLV-III-LAV,Infections, HIV,Infections, HTLV-III,Infections, HTLV-III-LAV,T Lymphotropic Virus Type III Infections, Human

Related Publications

Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
July 2015, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
January 2013, PloS one,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
April 2015, AIDS and behavior,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
March 2014, The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
March 2024, Journal of acquired immune deficiency syndromes (1999),
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
November 2000, AIDS patient care and STDs,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
July 2012, Journal of the International AIDS Society,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
March 2006, Journal of acquired immune deficiency syndromes (1999),
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
January 2016, PloS one,
Damalie Nalwanga, and Victor Musiime, and Paul Bangirana, and Erika Phelps Nishiguchi, and Andrew Kiggwe, and Titus Ssesanga, and John M Ssenkusu, and Philippa Musoke, and Sarah E Cusick
March 2009, Heart (British Cardiac Society),
Copied contents to your clipboard!