INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #29 Socioeconomic Status and HIV: Effects on Cognitive Growth in Children in Tanzania Toni Curry, Dartmouth Health, Lebanon, United States Erin McLean, Dartmouth Health, Lebanon, United States Jonathan Lichtenstein, Geisel School of Medicine, Hanover, United States Chris Niemczak, Geisel School of Medicine, Hanover, United States Albert Magohe, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, the United Republic of Abigail Fellows, Geisel School of Medicine, Hanover, United States Enica Massawe, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, the United Republic of Ndeserua Moshi, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, the United Republic of Jay Buckey, Geisel School of Medicine, Hanover, United States Category: Medical/Neurological Disorders/Other (Child) Keyword 1: HIV/AIDS Keyword 2: cognitive functioning Keyword 3: cross-cultural issues Objective: Beginning prior to birth and continuing into adulthood, socioeconomic status (SES) is associated with cognitive outcomes in children. HIV infection can produce central nervous system (CNS) dysfunction, placing children at increased risk for developmental delays, including impaired cognitive functioning. Although advances in HIV detection and modern antiretroviral drug regimens have resulted in sometimes undetectable viral loads, the interaction of SES, HIV, and cognitive function is unknown in those well-treated for HIV. In the current study, we examined interaction between SES, age, and HIV on cognitive performance over time in a cohort of children living in Tanzania. Participants and Methods: Participants were part of a longitudinal study in Dar es Salaam, Tanzania. Cognitive functioning was assessed using the Leiter International Performance Scale, Third Edition (Leiter-3). Gestures used during administration of this nonverbal measure were modified to communicate test instructions more meaningfully in the Tanzanian culture. Participants included 481 youth between the ages of 3 and 12 years. The children living with HIV (CLWH) group included 224 youth (M_age= 6.94, sd = 1.93; 50% female). Our healthy control cohort included 257 youth (M_age= 6.55, sd = 1.86; 53% female). All CLWH were taking antiretroviral drugs. To determine the relationship between the Leiter-3, SES, age, and HIV status, we used a linear mixed-effects model with Leiter-3 Composite as the outcome, with SES, HIV, and age as predictors, with interaction. Results: SES independently predicted scores on the Nonverbal IQ (β = 9.42, SE = 3.52, p=.007) and Processing Speed Composites (β = 6.18, SE = 3.01, p = .04), but not Nonverbal Memory (β = 4.31, SE = 2.96, p = 0.14). The interaction between SES and HIV was significant for Nonverbal IQ (β = -12.38, SE = 5.47, p = .024) and Nonverbal Memory (β = -11.12, SE = 4.59, p = .015), but not Processing Speed (β = -4.62, SE = 4.68, p = 0.32). Age was a significant independent predictor of all three Leiter-3 Composites, but the interaction between SES and age, and HIV and age, was not significant for any Leiter-3 Composites. Conclusions: As expected, higher SES was a significant predictor of better cognitive performance in our sample. For youth with HIV, however, the SES effect was blunted for Nonverbal IQ and Nonverbal Memory, as performance did not improve with higher SES. Healthy controls showed the expected trajectory of upward trending scores over the course of childhood. SES is known to be a protective factor of neurodevelopment and is associated with positive outcomes for youth. We found a similar phenomenon in Tanzanian youth but learned that the advantage of higher SES is reduced in children with HIV. Despite improvement in the health of individuals living with HIV, these data suggest that HIV is still affecting cognitive outcomes in CLWH.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #29

Socioeconomic Status and HIV: Effects on Cognitive Growth in Children in Tanzania

Toni Curry, Dartmouth Health, Lebanon, United States
Erin McLean, Dartmouth Health, Lebanon, United States
Jonathan Lichtenstein, Geisel School of Medicine, Hanover, United States
Chris Niemczak, Geisel School of Medicine, Hanover, United States
Albert Magohe, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, the United Republic of
Abigail Fellows, Geisel School of Medicine, Hanover, United States
Enica Massawe, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, the United Republic of
Ndeserua Moshi, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania, the United Republic of
Jay Buckey, Geisel School of Medicine, Hanover, United States

Category: Medical/Neurological Disorders/Other (Child)

Keyword 1: HIV/AIDS
Keyword 2: cognitive functioning
Keyword 3: cross-cultural issues

Objective:

Beginning prior to birth and continuing into adulthood, socioeconomic status (SES) is associated with cognitive outcomes in children. HIV infection can produce central nervous system (CNS) dysfunction, placing children at increased risk for developmental delays, including impaired cognitive functioning. Although advances in HIV detection and modern antiretroviral drug regimens have resulted in sometimes undetectable viral loads, the interaction of SES, HIV, and cognitive function is unknown in those well-treated for HIV. In the current study, we examined interaction between SES, age, and HIV on cognitive performance over time in a cohort of children living in Tanzania.

Participants and Methods:

Participants were part of a longitudinal study in Dar es Salaam, Tanzania. Cognitive functioning was assessed using the Leiter International Performance Scale, Third Edition (Leiter-3). Gestures used during administration of this nonverbal measure were modified to communicate test instructions more meaningfully in the Tanzanian culture. Participants included 481 youth between the ages of 3 and 12 years. The children living with HIV (CLWH) group included 224 youth (M_age= 6.94, sd = 1.93; 50% female). Our healthy control cohort included 257 youth (M_age= 6.55, sd = 1.86; 53% female). All CLWH were taking antiretroviral drugs. To determine the relationship between the Leiter-3, SES, age, and HIV status, we used a linear mixed-effects model with Leiter-3 Composite as the outcome, with SES, HIV, and age as predictors, with interaction.

Results:

SES independently predicted scores on the Nonverbal IQ (β = 9.42, SE = 3.52, p=.007) and Processing Speed Composites (β = 6.18, SE = 3.01, p = .04), but not Nonverbal Memory (β = 4.31, SE = 2.96, p = 0.14). The interaction between SES and HIV was significant for Nonverbal IQ (β = -12.38, SE = 5.47, p = .024) and Nonverbal Memory (β = -11.12, SE = 4.59, p = .015), but not Processing Speed (β = -4.62, SE = 4.68, p = 0.32). Age was a significant independent predictor of all three Leiter-3 Composites, but the interaction between SES and age, and HIV and age, was not significant for any Leiter-3 Composites.

Conclusions:

As expected, higher SES was a significant predictor of better cognitive performance in our sample. For youth with HIV, however, the SES effect was blunted for Nonverbal IQ and Nonverbal Memory, as performance did not improve with higher SES. Healthy controls showed the expected trajectory of upward trending scores over the course of childhood. SES is known to be a protective factor of neurodevelopment and is associated with positive outcomes for youth. We found a similar phenomenon in Tanzanian youth but learned that the advantage of higher SES is reduced in children with HIV. Despite improvement in the health of individuals living with HIV, these data suggest that HIV is still affecting cognitive outcomes in CLWH.