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Data indicate no link between ART and psychiatric illness in youth
Nachman S.Arch Pediatr Adolesc Med.2012; doi:10.1001/archpediatrics.2011.1785.
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Among perinatally HIV-infected youth, researchers found no association between specific antiretroviral therapy and the severity of psychiatric disorders, according to new findings.
“HIV medication did not cause psychiatric illness,” Sharon Nachman, MD, of the department of pediatrics at Stony Brook University, told Infectious Diseases in Children. “In fact, there were few specific HIV variables that were associated with the outcome of psychiatric disorders, but more importantly, low CD4 count and sustained high viral load actually had the biggest impact on how children functioned.”
For the cross-sectional analysis, a team of researchers led by Nachman aimed to assess the association between HIV severity and psychiatric and functional outcomes among 319 HIV-infected participants aged 6 to 17 years. Participants were enrolled in the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group (IMPAACT) study across 29 sites in the United States and Puerto Rico.
Researchers assessed the presence and severity of psychiatric symptoms including cognitive, social and academic functioning, as well as quality of life among those with current or past exposure to highly active antiretroviral therapy (HAART).
HIV illness severity markers (low CD4 percentage and high viral load) were associated with worse cognitive, academic and social functioning, “but did not have anything to do with predicting psychiatric disorders,” Nachman said.
“It’s the years of living with HIV, low CD4 count and high viral load that really predicts how the patient’s brain is functioning,” Nachman said. “That means we should think long and hard about whom we are treating and how we are treating them, and maybe we need to think about treating all children all the time. This is what’s happening in the adult world; there are a lot of questions about when to start ART.”
Disclosure: This research was supported by grant U01 AI068632 from the National Institute of Allergy and Infectious Diseases (NIAID), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and grant AI068632 from the National Institute of Mental Health (NIMH).
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