Behavioral impairment and cognition in Thai adolescents affected by HIV

Payal B Patel; Andrew Belden; Ryan Handoko; Thanyawee Puthanakit; Stephen Kerr; Pope Kosalaraksa; Pradthana Ounchanum; Suparat Kanjanavanit; Linda Aurpibul; Chaiwat Ngampiyasakul; Wicharn Luesomboon; Claude A Mellins; Kathleen Malee; Jintanat Ananworanich; Robert Paul

doi:10.1017/gmh.2021.1

Behavioral impairment and cognition in Thai adolescents affected by HIV

Glob Ment Health (Camb). 2021 Feb 9:8:e3. doi: 10.1017/gmh.2021.1. eCollection 2021.

Authors

Affiliations

¹ Department of Neurology, University of Washington, Seattle, WA, USA.
² University of Missouri, St. Louis, St. Louis, MO, USA.
³ Yale University, New Haven, CT, USA.
⁴ Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
⁵ Faculty of Medicine, HIV-NAT, The Thai Red Cross AIDS Research Center and Biostatistics Centre, Chulalongkorn University, Bangkok, Thailand.
⁶ Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
⁷ Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
⁸ Nakornping Hospital, Chiang Mai, Thailand.
⁹ Research Institute for Health Sciences (RIHES), Chiang Mai University, Thailand.
¹⁰ Prapokklao Hospital, Chantaburi, Thailand.
¹¹ Queen Savang Vadhana Memorial Hospital, Chonburi, Thailand.
¹² HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, and Columbia University, New York City, NY, USA.
¹³ Department of Psychiatry and Behavioral Science, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
¹⁴ Bill and Melinda Gates Medical Research Institute, Cambridge, MA, USA.
¹⁵ Missouri Institute of Mental Health, University of Missouri-St. Louis, Saint Louis, MO, USA.

Abstract

Background: Cognitive and behavioral impairment are common in children living with perinatally acquired HIV (pHIV) and children exposed to HIV in utero but uninfected (HEU).

Methods: We sought to determine the prevalence of adverse behavioral symptomatology using a Thai-translated and validated version of the SNAP-IV questionnaire and assess cognitive function utilizing the Children's Color Trails Test, Delis-Kaplan Executive Function System, and the Wechsler Intelligence Scales, in our cohort of Thai adolescents (10-20 years old) with well-controlled pHIV compared to HEU and HIV-unexposed, uninfected youth. We then evaluated the interaction between HIV status, behavioral impairment, and executive function outcomes independent of demographic variables.

Results: After controlling for demographic factors of age and household income, adolescents with pHIV had higher inattentive symptomatology and poorer neuropsychological test scores compared to uninfected controls. Significant interactions were found between inattention and executive function across multiple neurocognitive tests.

Conclusions: Behavioral impairment and poor executive functioning are present in adolescents with well-controlled pHIV compared to HIV-uninfected matched peers. The SNAP-IV questionnaire may be a useful tool to identify those with attentional impairment who may benefit from further cognitive testing in resource-limited settings.

Keywords: Adolescents; behavioral health; cognition; perinatal HIV.

Grants and funding

UL1 TR001863/TR/NCATS NIH HHS/United States