Drugs used to treat children infected with Human Immunodeficiency Virus (HIV) do not appear to increase the risk of psychiatric problems in children, U.S. researchers said.
Scientists have been worried about the high rates of psychiatric and academic problems in children infected with HIV, which causes AIDS.
“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?”? Dr Sharon Nachman of Stony Brook University, New York asked.
Nachman worked on the study published in Archives of Pediatrics and Adolescent Medicine.
In an earlier study, the team found similarly high rates of psychiatric problems in children with HIV and in those who have a family member with HIV, suggesting that stresses in the environment likely play some role.
For the latest study, Nachman and colleagues looked specifically at children with HIV in an attempt to find some of the answers.
They analyzed data on 319 HIV-infected children and adolescents aged between six and 17 years, who were enrolled in the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group study.
A third of the children had, at least, one psychiatric disorder, such as depression or attention deficit hyperactivity disorder (ADHD).
The team also reviewed the children's disease history and markers of disease severity, such as their viral load — the levels of the virus in their blood — and measures of infection-fighting cells, known as CD4 cells.
The team found no link between the HIV drugs known as antiretrovirals that the children were taking to control their disease and any psychiatric problem.
“It wasn't the antiretrovirals. 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, Nachman said in a telephone interview.
When they looked at severity of the disease, as measured by how much virus was in the blood or how well the immune system was working, the results were mixed.
For example, they said children who entered the study with a lower CD4 percentage — a reflection of the number of infection-fighting cells in the blood — had less severe depression.
But children who had high levels of the HIV virus in their blood when they entered the study had more severe depression.
However, severity of disease did appear to play a role when it came to critical cognitive skills known as executive functioning.
The team found children who had the most severe disease when they entered the study did worse on tests of executive functioning, such as remembering a sequence of numbers.
“It appears if you had a high viral load at a young age or a low CD4 percentage, you did get a hit on your brain” in terms of executive functioning, Nachman said.
The study does not prove cause and effect but Nachman said it suggested that HIV infection could affect the brain.
Some doctors are debating about whether to treat a child who has less severe disease, Nachman said, but added that tests of the immune system or levels of the virus might not reveal the whole picture.
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