Reuters (02.07.12) - Friday, February 10, 2012
Antiretroviral therapy does not appear to increase the risk of
psychiatric problems in children with HIV, a new study
suggests. Scientists have been worried about high rates of
psychiatric and academic problems in children with HIV.
"The question that is coming up is, 'Why do they have so many
issues? Is it their HIV, is it their antiretrovirals or is it
other factors?'" said study author Dr. Sharon Nachman of Stony
Brook University in New York.
In an earlier study, Nachman and colleagues found that
children with HIV and those with an HIV-positive family member
had similarly high rates of psychiatric problems, suggesting
environmental stressors. The new study analyzed data on 319
HIV-infected children and adolescents ages six to 17 enrolled
in the International Maternal Pediatrics Adolescent AIDS
Clinical Trials Group study in the United States and Puerto
One-third of the children had at least one psychiatric
disorder, such as depression or attention-deficit
hyperactivity disorder (ADHD). However, no link was found
between antiretroviral therapy and any psychiatric problem.
"It wasn't the antiretrovirals," Nachman said. "It didn't
matter which antiretrovirals the kids used. Those didn't
predict or prevent a kid from getting a psychiatric illness"
or having social or academic problems, she said.
In looking at markers of the severity of the disease, such as
CD4 cell levels and viral loads, the results were mixed.
Children with a lower CD4 percentage at baseline had less
severe depression. Those with high viral loads at baseline had
more severe depression. Children with the most severe disease
at baseline did worse on cognitive tests of executive
functioning, such as remembering a sequence of numbers,
"It appears if you had a high viral load at a younger age or a
low CD4 percentage, you did get a hit on your brain" in terms
of executive function, Nachman said. The study did not prove
cause and effect, but it suggests HIV infection could affect
the brain, she said.
The full report, "Human Immunodeficiency Virus Disease
Severity, Psychiatric Symptoms, and Functional Outcomes in
Perinatally Infected Youth," was published online in Archives
of Pediatrics & Adolescent Medicine