Barcelona 2013
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| Abstract #395 - Theory and Overview | ||||
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Session: 14.2: Theory and Overview (Parallel) on Monday @ 14.30-16.00 in Raval Chaired by Richard Harding, Sheana Bull Authors: Presenting Author: Miss Natasha Croome - UCL, United Kingdom |
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| Additional Authors: | ||||
| Aim: This study aims to provide a comprehensive understanding of the cognitive effects of HIV on child development for children who are HIV+ve and those who are HIV exposed but uninfected and to systematically review effective interventions to address any delays. | ||||
| Method / Issue: The paper will cover three separate systematic review initiatives where key word searches according to the Cochrane methodology were conducted to examine the effect of HIV on cognitive development for HIV+ve children. The search generated 1,739 which were screened and 21 met inclusion criteria. A second review examined all studies where there was data on HIV affected children (the future majority) compared to uninfected unexposed controls. 12 studies were identified. Finally a review of any interventions was carried out where 1,646 hits were scanned and only 3 papers met inclusion criteria. | ||||
| Results / Comments: Cognitive delay in HIV positive children is well documented now. Of the studies reviewed 81% showed deficit on at least one measure. More recent studies have expanded the breadth of enquiry with measurements of a variety of cognitive domains. 31 different measures were used making meta analysis difficult. Of concern was the fact that HIV exposed but negative children also appeared to show a stepwise delay relative to uninfected unexposed controls. Although there were only 3 interventions, these offered effective tools for HIV specific groups. The broader literature on cognitive and developmental delay has more to offer in terms of interventions. | ||||
| Discussion: These reviews show that cognitive functioning and developmental delay is a neglected issue for children. Routine measurement is important if children are to reach their potential. Evaluation of effective interventions is crucial and community based provision, such as special educational support should be considered. The advent of treatment to pregnant mothers will reduce the numbers of future HIV positive children but HIV affected children will still require support. Causal mechanisms are difficult to disentangle with contributions from the virus itself, treatments, ill parents and environmental factors. | ||||
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