Evidence map›Paper›PMID 38598467›Full record

ArticlePloS one2024

Language outcomes of preschool children who are HIV-exposed uninfected: An analysis of a South African cohort.

Freddy Green, Christopher du Plooy, Andrea M Rehman, Raymond T Nhapi, Marilyn T Lake, Whitney Barnett, Nadia Hoffman, Heather J Zar, Kirsten A Donald, Dan J Stein and 1 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 3 countries.

Freddy GreenDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Christopher du PlooyDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-4403-4072
Andrea M RehmanMRC International Statistics & Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID 0000-0001-9967-5822
Raymond T NhapiDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Marilyn T LakeDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Whitney BarnettDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Nadia HoffmanDepartment of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.
Heather J ZarDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Kirsten A DonaldDepartment of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-0276-9660
Dan J SteinDepartment of Psychiatry & Mental Health, University of Cape Town, Cape Town, South Africa.
Catherine J WedderburnDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom.ORCID 0000-0002-4887-1644
University of Cape Town · ZASouth African Medical Research Council · ZALondon School of Hygiene & Tropical Medicine · GB

Funding

Cross-Cultural Assessment of FASDU24AA014811 · NIAAA · SAN DIEGO STATE UNIVERSITY · PI EDWARD P RILEY · 2003 to 2026
$13.1M
A neuroimaging study of 2 year old children with alcohol exposure compared to healthy unexposed controls embedded in a birth cohort studyR21AA023887 · NIAAA · UNIVERSITY OF CAPE TOWN · PI DONALD, KIRSTY · 2016 to 2017
$280k
NIAAA NIH HHS R21 AA023887NIAAA NIH HHS U24 AA014811Wellcome Trust
6 · The paper itself

Abstract

introductionThere are approximately 16 million children who are HIV-exposed and uninfected (CHEU) worldwide. Studies suggest that CHEU are at risk for developmental impairment in infancy, particularly in language domains. However, there is limited research examining neurocognitive function in CHEU older than 2 years, including important pre-school years. This study aimed to investigate associations between HIV exposure without infection and neurocognitive outcomes and to determine risk factors for neurodevelopment in CHEU at age 3-4 years.

methodsThe Drakenstein Child Health Study is a South African population-based birth cohort which enrolled women in pregnancy with ongoing follow up. Neurocognitive outcomes were assessed in children at 3.5 years by trained assessors blinded to HIV status including general cognitive function, language, and memory, measured using the Kaufmann Assessment Battery for Children, Second Edition (KABC-II). Data were compared between CHEU and children who were HIV-unexposed uninfected (CHUU) using multivariable logistic and linear regression, including testing for effect modification; sex-stratified risk factor analyses were performed.

resultsA total of 497 children were included (97 [20%] CHEU; 400 [80%] CHUU; 50% male), with a mean age of 3.5 years (range 3.4-3.6). Groups had similar birth and household characteristics, although mothers of CHEU were older, on average. Overall, CHEU had lower expressive language scores compared to CHUU on unadjusted and adjusted analyses (effect size: -0.23 [95% CI -0.45, -0.01]). There were no group differences in general cognitive or memory function (p>0.05). On sex-stratified analyses, male CHEU were found to have higher odds of suboptimal cognitive development compared to male CHUU (aOR 2.28 [95% CI 1.06, 4.87], p = 0.034). Several other factors including birthweight, maternal education, maternal ART duration and HIV viral load during pregnancy were associated with cognition, memory, or expressive language outcomes in CHEU, dependent on child sex.

interpretationThe findings suggest that perinatal HIV exposure continues to be associated with impaired language development across the preschool years, highlighting the importance of targeting early interventions to optimise language outcomes. Further, the results suggest the importance of demographic, biological and HIV-related variables influencing developmental outcomes in CHEU. The greater risk of suboptimal cognitive development in male CHEU requires investigation around sex-specific mechanisms.

Indexed as

HIV InfectionsPregnancy Complications, InfectiousChild, PreschoolCognitionFemaleHumansMaleMothersPregnancyRisk FactorsSouth Africa

Identifiers

PMID38598467
PMCPMC11006185
OpenAlexW4394675181

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.