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Association of in utero HIV exposure with child brain structure and language development: a South African birth cohort study.

التفاصيل البيبلوغرافية
العنوان: Association of in utero HIV exposure with child brain structure and language development: a South African birth cohort study.
المؤلفون: Wedderburn CJ; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa. catherine.wedderburn@uct.ac.za.; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK. catherine.wedderburn@uct.ac.za.; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa. catherine.wedderburn@uct.ac.za., Yeung S; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK., Subramoney S; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa., Fouche JP; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa., Joshi SH; Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA.; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, USA., Narr KL; Departments of Neurology, Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA., Rehman AM; MRC International Statistics & Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK., Roos A; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; SA MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa., Gibb DM; MRC Clinical Trials Unit, University College London, London, UK., Zar HJ; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; SA MRC Unit On Child & Adolescent Health, University of Cape Town, Cape Town, South Africa., Stein DJ; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.; Department of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.; SA MRC Unit On Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa., Donald KA; Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.; The Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
المصدر: BMC medicine [BMC Med] 2024 Mar 22; Vol. 22 (1), pp. 129. Date of Electronic Publication: 2024 Mar 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101190723 Publication Model: Electronic Cited Medium: Internet ISSN: 1741-7015 (Electronic) Linking ISSN: 17417015 NLM ISO Abbreviation: BMC Med Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2003-
مواضيع طبية MeSH: Pregnancy Complications, Infectious*/diagnostic imaging , Pregnancy Complications, Infectious*/epidemiology , HIV Infections*/complications , HIV Infections*/epidemiology, Infant ; Humans ; Pregnancy ; Female ; Cohort Studies ; South Africa/epidemiology ; Prospective Studies ; Brain/diagnostic imaging
مستخلص: Background: There is a growing population of children with in utero HIV exposure who are at risk of poor neurodevelopmental outcomes despite avoiding HIV infection. However, the underlying neurobiological pathways are not understood and neuroimaging studies are lacking. We aimed to investigate the cortical brain structure of children who are HIV-exposed and uninfected (HEU) compared to HIV-unexposed (HU) children and to examine the relationship with neurodevelopment.
Methods: The Drakenstein Child Health birth cohort study enrolled pregnant women from a high HIV prevalence area in South Africa with longitudinal follow-up of mother-child pairs. High-resolution magnetic resonance imaging scans from 162 children (70 HEU; 92 HU) were acquired at 2-3 years of age. All HEU children were born to mothers taking antiretroviral therapy. Measures of brain structure (cortical thickness and surface area) in the prefrontal cortex regions were extracted from T1-weighted images and compared between groups using multivariate analysis of variance and linear regression. Child development, assessed using the Bayley Scales of Infant and Toddler Development-III, was correlated with cortical structure, and mediation analyses were performed.
Results: Analyses demonstrated an association between HIV exposure and cortical thickness across the prefrontal cortex (p = 0.035). Children who were HEU had thicker cortices in prefrontal regions, with significantly greater cortical thickness in the medial orbitofrontal cortex (mOFC) bilaterally compared to HU children (3.21 mm versus 3.14 mm, p = 0.009, adjusted effect size 0.44 [95% CI 0.12 to 0.75]). Estimates held across multiple sensitivity analyses. There were no group differences in cortical surface area. Language scores, which were lower in HEU versus HU children (81.82 versus 86.25, p = 0.011, effect size - 0.44 [95% CI - 0.78 to - 0.09]), negatively correlated with prefrontal cortical thickness in both groups. Cortical thickness in the mOFC mediated the relationship between HIV exposure and poor language outcomes (Sobel test p = 0.032).
Conclusions: In this cohort study, exposure to HIV during pregnancy was associated with altered cortical structure in early life. Our findings indicate that differences in cortical thickness development in the prefrontal region in children who are HEU may be a pathway leading to language impairment. Longitudinal studies are needed to determine the lasting impact.
(© 2024. The Author(s).)
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معلومات مُعتمدة: R21AA023887 United States AA NIAAA NIH HHS; MR/R010161/1 United Kingdom MRC_ Medical Research Council; U24 AA014811 United States AA NIAAA NIH HHS; 203525/Z/16/Z United Kingdom WT_ Wellcome Trust; United Kingdom WT_ Wellcome Trust; NAF002/1001 United Kingdom AMS_ Academy of Medical Sciences
فهرسة مساهمة: Keywords: Antiretroviral therapy; Brain structure; HIV; Language; Magnetic resonance imaging; Neurodevelopment
تواريخ الأحداث: Date Created: 20240323 Date Completed: 20240325 Latest Revision: 20240326
رمز التحديث: 20240326
مُعرف محوري في PubMed: PMC10960435
DOI: 10.1186/s12916-024-03282-6
PMID: 38519887
قاعدة البيانات: MEDLINE
الوصف
تدمد:1741-7015
DOI:10.1186/s12916-024-03282-6