Timing of perinatal human immunodeficiency virus type 1 infection and rate of neurodevelopment

Renee Smith, Kathleen Malee, Manhattan Charurat, Larry Magder, Claude Mellins, Carol MacMillan, Joan Hittleman, Tamar Lasky, Antolin Llorente, Jack Moye

Research output: Contribution to journalArticlepeer-review

57 Scopus citations


Background. Identifying HIV-1-infected children who are at greatest risk for disease-related morbidities is critical for optimal therapeutic as well as preventive care. Several factors have been implicated in HIV-1 disease onset and severity, including maternal and infant host characteristics, viral phenotype and timing of HIV-1 infection. Early HIV-1 culture positivity, i.e. intrauterine infection, has been associated with poor immunologic, virologic and clinical outcomes in children of HIV-infected women. However, a direct effect of timing of infection on neurodevelopmental outcome in infancy has not yet been identified. Methods. Serial neurodevelopmental assessments were performed with 114 infants vertically infected with HIV-1 in a multicenter natural history, longitudinal study. Median mental and motor scores were compared at three time points. Longitudinal regression analyses were used to evaluate the neurodevelopmental functioning of children with early positive cultures and those with late positive cultures. Results. Early infected infants scored significantly lower than late infected infants by 24 months of age and beyond on both mental (P = 0.05) and motor (P = 0.03) measures. Early HIV-1 infection was associated with a decline in estimated motor scores of 1 standard score point per month compared with 0.28 point in the late infected group (P < 0.02). Estimated mental scores of the early infected group declined 0.72 point/month, whereas the average decline of the late infected group was 0.30 point/month (P < 0.13). Conclusion. Early HIV-1 infection increases a child's risk for poor neurodevelopmental functioning within the first 30 months of life.

Original languageEnglish (US)
Pages (from-to)862-871
Number of pages10
JournalPediatric Infectious Disease Journal
Issue number9
StatePublished - 2000

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases


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