Perinatal HIV-exposure associated with language impairments in preschool children
BOSTON — An increased risk for language impairment was observed among HIV-exposed but uninfected children aged 3 to 5 years; however, no overall risk was found to be associated with ART, according to data presented at CROI 2016.
“The study joins a handful of recent reports describing the elevated risk of language impairments in children perinatally HIV-exposed and uninfected, and provides new information for the formative period of 3 to 5 years in children’s language acquisition — a period vital for the development of language needed for academic success later on,” Mabel L. Rice, PhD, director of the child language doctoral program at the University of Kansas, told Infectious Diseases in Children. “Elevated risk, compared to age referent norms, is evident across different dimensions of language.”
Mabel L. Rice
The researchers conducted speech and language assessments of 238 HIV-exposed children aged 3 years and 465 children aged 5 years, including 145 originally assessed at age 3. Children were tested for domains of speech, overall language ability, vocabulary and grammar. The researchers defined speech and language impairment as standardized scores below the 15th percentile. Rice and colleagues estimated the adjusted odds of speech and language impairment through statistical analysis.
Data showed that HIV-exposed children had lower standardized scores for vocabulary compared with population norms at age 3 years. Standardized scores for overall language, vocabulary and grammar also were lower among HIV-exposed children at age 5 years. Speech impairment was not found in either age population.
The researchers reported that the use of tenofovir (P = .01) and nelfinavir (P = .05) as ART was associated with protective effects for grammar and language, respectively, at age 5 years. However, increased risk for impaired speech was determined at age 3 years with tenofovir (P = .04), and increased risks for vocabulary and language were observed at age 5 years with didanosine (P = .02) and zidovudine (P = .05).
“Overall, there is no consistently strong evidence of a relationship between ART exposure and speech or language impairments,” Rice said. “Clinicians should be alert to possible language impairments in preschool children perinatally HIV-exposed and uninfected, and support intervention to prevent continued elevated risk at school entry and beyond.” – by David Costill
Rice ML, et al. Abstract 813. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 22-25, 2016; Boston.
Disclosure: The researchers report no relevant financial disclosures.