Longitudinal development of cognitive, visuomotor and adaptive behavior skills in HIV uninfected children, aged 3–5 years of age, exposed pre- and perinatally to anti-retroviral medications

The success of prevention of mother-to-child transmission programs means that more babies are being born HIV-free, however, little is known about the developmental outcomes for children who are HIV-uninfected (HEU) but who have been exposed to antiretrovirals early in life. A recent systematic review of the psychological functioning of children exposed to HIV recommended an urgent need for following these children over time. In this longitudinal study of cognitive, visuomotor and adaptive function of HEU children, who were assessed at ages, 3.5 and 5.5 years, the goal was t o determine the medical and socio-demographic factors that were associated with function at those two ages, and to evaluate the change (and predictors of such change) between the two ages. Sixty-four children from a pediatric HIV referral hospital in Toronto were assessed. The results reveal subtle but statistically significant differences in development at the two ages and suggest that the full impact of early ARV exposure may not be evident until a considerable period of development has occurred. The results raise the possibility of negative effects of early ARV exposure on neuro-development that emerge over time.