Details

Autor(en) / Beteiligte

• Nalwanga, Damalie
• Moraleda, Cinta
• Tagoola, Abner
• Lubega, John Paul
• Nalunkuma, Amina
• Kakooza, Lawrence
• Kiggwe, Andrew
• Mbabazi, Bashira
• Nkinzi, Sharafat
• Ballesteros, Alvaro
• Tagarro, Alfredo
• Rojo, Pablo
• Musiime, Victor

Titel

PA-655 Severe pneumonia is associated with worse neurocognitive function among infants living with HIV

Ist Teil von

• BMJ global health, 2023-12, Vol.8 (Suppl 10), p.A105-A105

Ort / Verlag

London: BMJ Publishing Group Ltd

Erscheinungsjahr

2023

Quelle

EZB Free E-Journals

Beschreibungen/Notizen

• BackgroundDespite reduction of HIV-associated mortality in children with the implementation of antiretroviral treatment (ART), HIV-associated neurocognitive deficits are still of great concern. These are thought to result mainly from intra-cranial HIV-associated pathology. The contribution of extra-cranial infections like pneumonia is not well described. We compared neurocognitive function between infants living with HIV (ILHIV), with and without severe pneumonia. MethodsThis EDCTP-funded case-control study (TMA2020CDF-3198) was conducted among ILHIV with severe pneumonia enrolled in the EMPIRICAL trial (#NCT03915366) (cases), and age-matched ILHIV without severe pneumonia (controls). We assessed neurocognitive function using the Bayley’s Scales of Infant and Toddler Development-III within 3weeks of hospital discharge or recruitment among cases and controls respectively. We compared demographic and clinical characteristics as well as neurocognitive mean scaled scores between the two groups.ResultsAmong 66 infants (44 cases and 22 controls) included in the study, 36 (54.5%) were male and the median age was 6 months (IQR = 4.47 - 8.98). There was no difference in age (p = 0.83), sex distribution (p = 0.43), prematurity proportions (p = 0.16), breastfeeding (p = 0.56) proportion on ART and its duration, (p = 0.05, and p = 0.07 respectively), viral load (p = 0.28), or hemoglobin (p = 0.06). The cases had lower weight-for-height z-scores than the controls (-1.73 [IQR = -2.68 – 0.44] vs -0.08 [IQR = -1.85 - 0.85] respectively, p = 0.04). There was no difference in family care indicators between groups. Among infants with complete data, the cases (n=40) scored poorer than the controls (n=18) in all neurocognitive domains; cognitive (p = <0.01), language (p = 0.04), and motor (p = <0.01).ConclusionSevere pneumonia increases the likelihood of neurocognitive deficits among ILHIV. Interventions reducing the risk and severity of pneumonia may be beneficial in reducing neurocognitive decline in this population.