Significant differences between verbal and non-verbal intellectual scales on a perinatally HIV-infected cohort: from pediatrics to young adults
C. García-Navarro,
S. Jimenez de Ory,
C. Velo Higueras,
B. Zamora,
L. Prieto,
J.T. Ramos,
M.L. Navarro,
L. Escosa-García,
R. Jurado-Barba,
Dolores Falcón,
David Moreno,
M.I. González-Tomé
Affiliations
C. García-Navarro
Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Spain; Corresponding author.
S. Jimenez de Ory
Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón (IisGM), Spain
C. Velo Higueras
Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain; Research Institute Hospital 12 de Octubre (i+12), Spain
B. Zamora
Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain
L. Prieto
Department of Pediatrics, Hospital Universitario de Getafe, Madrid, Spain
J.T. Ramos
Department of Pediatrics, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Salud Pública y Materno-Infantil UCM, Spain; Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Spain
M.L. Navarro
Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón (IisGM), Spain; Departamento de Salud Pública y Materno-Infantil UCM, Spain; Translational Research Network in Pediatric Infectious Diseases (RITIP), Spain
L. Escosa-García
Department of Pediatric HIV and Infectious Diseases, Hospital Universitario La Paz, Madrid, Spain; La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
R. Jurado-Barba
Research Institute Hospital 12 de Octubre (i+12), Spain; Department of Psychology, Facultad de Educación y Salud, Universidad Camilo José Cela, Madrid, Spain
Dolores Falcón
Department of Paediatrics, Hospital Virgen del Rocío, Sevilla, Spain
David Moreno
Department of Pediatrics, Pediatric Infectology & Immunodeficiency Unit, Regional University Children's Hospital of Malaga, Malaga, Spain; IBIMA Multidisciplinary Group for Pediatric Research of Malaga, Malaga University, Malaga, Spain
M.I. González-Tomé
Department of Pediatrics, Hospital Universitario 12 de Octubre, Madrid, Spain; Corresponding author.
Delayed neurodevelopment is a common outcome in perinatally HIV-infected children. Our aim was to assess the intellectual profile of our cohort, considering both the infection and socio-environmental related variables. A cross-sectional cohort study was undertaken at seven major hospitals in Spain belonging to the CoRISpeS cohort (n = 97). Patients were followed up according to a standard protocol. Intellectual measures, psychosocial profile and HIV infection-related data have been analysed. The average patient age was 15 years. The median CD4 cell percentage was 35% (1,59). Viral load was undetectable in 80% of the patients and 27% were on AIDS category; 38% of whom had encephalopathy. The average composite score of both crystallized intelligence (CI) and intelligence quotient (IQ) for the cohort was lower than that of the general population (p < 0.001). Results revealed a significant difference of 38% between crystallized and fluid intelligence. There was a clear association between IQ and age of diagnosis (p = 0.022); CI and CDC classification (p = 0.035), CD4 count (p = 0.011) and CD4 nadir (p = 0.001). Higher parental education was associated with better performance across all intelligence scales (p < 0.002). A regression model showed that CI was influenced by the academic level of caregivers (p = 0.002), age at start of cART (p = 0.050) and primary language (p = 0.058). Findings revealed significant differences in verbal and non-verbal intellectual scales resulting in a misleading IQ Composite score. Crystallized intelligence demonstrated the highest level of impairment despite adequate treatment and good immunovirological status, while fluid intelligence results were average. Caregiver level of education was the strongest factor across all intelligence measures.
