TY - JOUR
T1 - Relationships between markers of vascular dysfunction and neurodevelopmental outcomes in perinatally HIV-infected youth
AU - Kapetanovic, Suad
AU - Leister, Erin
AU - Nichols, Sharon
AU - Miller, Tracie
AU - Tassiopoulos, Katherine
AU - Hazra, Rohan
AU - Gelbard, Harris A.
AU - Malee, Kathleen M.
AU - Kammerer, Betsy
AU - Mendez, Armando J.
AU - Williams, Paige L.
PY - 2010/6/19
Y1 - 2010/6/19
N2 - Objective: To examine the relationship between markers of vascular dysfunction and neurodevelopmental status in pediatric HIV disease. Design: A cross-sectional design within a prospective, 15-site cohort study conducted in the United States. Methods: Nine vascular biomarkers were examined in 89 HIV-infected children: soluble P-selectin/sCD62P, fibrinogen, adiponectin, monocyte chemoattractant protein-1/CCL-2, interleukin-6, C-reactive protein, soluble vascular cell adhesion molecule-1/sCD106, sE-selectin/sCD62E, and soluble intercellular adhesion molecule-1/sCD54. The Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) was administered yielding indices for verbal comprehension, perceptual reasoning, working memory and processing speed, and overall composite Full-Scale IQ score. Linear regression models were used to evaluate neurodevelopmental status (measured by WISC-IV scores) as a function of each biomarker while adjusting for demographics, disease severity, and receipt of HAART. Biomarker levels were evaluated in quartiles to evaluate trends in WISC-IV responses. Results: Among the 89 HIV-infected children (median age = 12 years), 56% were girls, 71% black, 16% Hispanic, and 43% had yearly household income below US $20 000. Log (soluble P-selectin) was significantly correlated with all WISC-IV scores; adjusted slopes showed 6-11-point average decrease in scores for each one log unit increase in soluble P-selectin. Final linear regression models for log (fibrinogen) adjusted for sociodemographic and disease characteristics also indicated a negative correlation with all WISC-IV scores (13-30-point decrease for each one log unit increase in fibrinogen); these decreases were significant in the verbal comprehension, perceptual reasoning, and Full-Scale IQ scores. Conclusion: Proinflammatory microvascular and immunologic mechanisms may be involved in neurodevelopmental impairment in children with perinatally acquired HIV disease.
AB - Objective: To examine the relationship between markers of vascular dysfunction and neurodevelopmental status in pediatric HIV disease. Design: A cross-sectional design within a prospective, 15-site cohort study conducted in the United States. Methods: Nine vascular biomarkers were examined in 89 HIV-infected children: soluble P-selectin/sCD62P, fibrinogen, adiponectin, monocyte chemoattractant protein-1/CCL-2, interleukin-6, C-reactive protein, soluble vascular cell adhesion molecule-1/sCD106, sE-selectin/sCD62E, and soluble intercellular adhesion molecule-1/sCD54. The Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) was administered yielding indices for verbal comprehension, perceptual reasoning, working memory and processing speed, and overall composite Full-Scale IQ score. Linear regression models were used to evaluate neurodevelopmental status (measured by WISC-IV scores) as a function of each biomarker while adjusting for demographics, disease severity, and receipt of HAART. Biomarker levels were evaluated in quartiles to evaluate trends in WISC-IV responses. Results: Among the 89 HIV-infected children (median age = 12 years), 56% were girls, 71% black, 16% Hispanic, and 43% had yearly household income below US $20 000. Log (soluble P-selectin) was significantly correlated with all WISC-IV scores; adjusted slopes showed 6-11-point average decrease in scores for each one log unit increase in soluble P-selectin. Final linear regression models for log (fibrinogen) adjusted for sociodemographic and disease characteristics also indicated a negative correlation with all WISC-IV scores (13-30-point decrease for each one log unit increase in fibrinogen); these decreases were significant in the verbal comprehension, perceptual reasoning, and Full-Scale IQ scores. Conclusion: Proinflammatory microvascular and immunologic mechanisms may be involved in neurodevelopmental impairment in children with perinatally acquired HIV disease.
KW - pediatric HIV
KW - pediatric NeuroAIDS
KW - role of chemokines in NeuroAIDS
KW - vascular dysfunction and NeuroAIDS
UR - http://www.scopus.com/inward/record.url?scp=77953913454&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953913454&partnerID=8YFLogxK
U2 - 10.1097/QAD.0b013e32833a241b
DO - 10.1097/QAD.0b013e32833a241b
M3 - Article
C2 - 20539091
AN - SCOPUS:77953913454
VL - 24
SP - 1481
EP - 1491
JO - AIDS
JF - AIDS
SN - 0269-9370
IS - 10
ER -
