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Effects of highly active antiretroviral therapy (HAART) on psychomotor performance in children with HIV disease

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Abstract

Objective

This study assesses the effects of HAART on psychomotor performance of symptomatic HIV-infected children. It is one of the first studies to look at neurobehavioral functioning in children infected with HIV in resource-limited countries.

Design

A longitudinal pilot study of vertically HIV-infected children at the HIV Netherlands Australia Thailand Research Collaboration Center in Bangkok, Thailand.

Methods

A total of 34 children participated in the study of whom 16 had never received antiretroviral (ARV) therapy and were about to start HAART (Newly treated children), 7 did not receive antiretroviral therapy (Untreated children) and 11 had been treated with HAART for more than one year (HAART experienced children). All children were administered 4 psychomotor tasks at baseline and after 4 months. The Newly treated and the Untreated children were also evaluated after 12 months.

Results

In general, the children performed similarly on all psychomotor tasks at baseline. After 12 months of HAART, there was a significant increase in CD4% in the Newly treated group. Overall, psychomotor performance did not change at the 4-month evaluation in all groups. At the 12-month evaluation psychomotor performance had deteriorated substantially on all tasks in both the Newly treated and the Untreated children.

Conclusions

There was no significant difference in psychomotor functioning between children newly treated, previously treated and untreated with HAART over the course of one year. Psychomotor performance deteriorated after 12 months of HAART, which provides important indications concerning the lack of benefits of HAART on psychomotor functions in children despite immunologic reconstitution. Further research with larger sample sizes is needed to confirm these findings.

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Acknowledgements

We received unrestricted educational grants from the International Antiviral Therapy Evaluation Center (IATEC), Amsterdam, The Netherlands and the Christine Bader Fund, Doesburg, The Netherlands.

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Authors and Affiliations

  1. Dept. of Clinical Neuropsychology, Faculty of Social Sciences, VU University, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands

    Sanneke Koekkoek & Laura Eggermont

  2. Dept. of Clinical Child and Adolescent Studies, Faculty of Social Sciences, Leiden University, Leiden, The Netherlands

    Leo De Sonneville

  3. The HIV Netherlands Australia Thailand, Research Collaboration, The Thai Red Cross AIDS Research Center, Bangkok, Thailand

    Thidakat Jupimai, Saijai Wicharuk, Wichitea Apateerapong, Theshinee Chuenyam, Joep Lange, Praphan Phanuphak & Jintanat Ananworanich

  4. The International Antiviral Therapy, Evaluation Center, Amsterdam, The Netherlands

    Sanneke Koekkoek, Laura Eggermont, Joep Lange & Ferdinand Wit

  5. Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Joep Lange

  6. Chulalongkorn University, Bangkok, Thailand

    Chitsanu Pancharoen & Praphan Phanuphak

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  1. Sanneke Koekkoek
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  2. Laura Eggermont
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  3. Leo De Sonneville
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Corresponding author

Correspondence to Sanneke Koekkoek.

Additional information

Received in revised form: 3 March 2006

S. Koekkoek and L. Eggermont contributed to this work equally

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Koekkoek, S., Eggermont, L., De Sonneville, L. et al. Effects of highly active antiretroviral therapy (HAART) on psychomotor performance in children with HIV disease. J Neurol 253, 1615–1624 (2006). https://doi.org/10.1007/s00415-006-0277-x

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