{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:15:20Z","timestamp":1787501720812,"version":"build-2736575974"},"reference-count":66,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T00:00:00Z","timestamp":1618531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["NIH R21HD088169"],"award-info":[{"award-number":["NIH R21HD088169"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To quantify association between\n                      <jats:italic>in utero<\/jats:italic>\n                      \/peripartum antiretroviral (IPA) exposure and cognition, i.e. executive function (EF) and socioemotional adjustment (SEA), in school\u2010aged Ugandan children who were perinatally HIV\u2010infected (CPHIV,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0100) and children who were HIV\u2010exposed but uninfected (CHEU,\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0101).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children were enrolled at age 6\u201310\u00a0years and followed for 12\u00a0months from March 2017 to December 2018. Caregiver\u2010reported child EF and SEA competencies were assessed using validated questionnaires at baseline, 6 and 12\u00a0months. IPA type \u2013 combination antiretroviral therapy (cART), intrapartum single\u2010dose nevirapine\u00a0\u00b1\u00a0zidovudine (sdNVP\u00a0\u00b1\u00a0ZDV), nevirapine\u00a0+\u00a0zidovudine\u00a0+\u00a0lamivudine (sdNVP\u00a0+\u00a0ZDV\u00a0+\u00a03TC) \u2013 or no IPA (reference) was verified via medical records. IPA\u2010related standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs) in cognitive competencies were estimated from regression models with adjustment for caregiver sociodemographic and contextual factors. Models were fitted separately for CPHIV and CHEU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among CPHIV children, cART (SMD\u00a0=\u00a0\u22120.82, 95% CI: \u22121.37 to \u22120.28) and sdNVP\u00a0\u00b1\u00a0ZDV (SMD\u00a0=\u00a0\u22120.41, 95% CI: \u22120.81 to \u22120.00)\n                      <jats:italic>vs<\/jats:italic>\n                      . no IPA predicted lower executive dysfunction over 12\u00a0months. Intrapartum sdNVP\u00a0+\u00a0ZDV\u00a0+\u00a03TC\n                      <jats:italic>vs<\/jats:italic>\n                      . no IPA predicted executive dysfunction (SMD\u00a0=\u00a00.80, 95% CI: 0.30\u20131.31), SEA problems (SMD\u00a0=\u00a00.63\u20130.76, 95% CI: 0.00\u20131.24) and lower adaptive skills (SMD\u00a0=\u00a0\u22120.36, 95% CI: \u22120.75\u20130.02) over 12\u00a0months among CHEU. Further adjustment for contextual factors attenuated associations, although most remained of moderate clinical importance (|SMD|\u00a0&gt;\u00a00.33).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Among CPHIV children, cART and sdNVP\u00a0\u00b1\u00a0ZDV IPA exposure predicted, on average, lower executive dysfunction 6\u201310\u00a0years later. However, peripartum sdNVP\u00a0+\u00a0ZDV\u00a0+\u00a03TC predicted executive and SEA dysfunction among CHEU 6\u201310\u00a0years later. These data underscore the need for more research into long\u2010term effects of\n                      <jats:italic>in utero<\/jats:italic>\n                      ART to inform development of appropriate interventions so as to mitigate cognitive sequelae.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hiv.13094","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T17:27:33Z","timestamp":1618594053000},"page":"592-604","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["<i>In\u00a0utero<\/i>\n                    and peripartum antiretroviral exposure as predictor of cognition in 6\u2010 to 10\u2010year\u2010old HIV\u2010exposed Ugandan children \u2013 a prospective cohort study"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2164-8802","authenticated-orcid":false,"given":"AE","family":"Ezeamama","sequence":"first","affiliation":[{"name":"Department of Psychiatry College of Osteopathic Medicine Michigan State University East Lansing MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SK","family":"Zalwango","sequence":"additional","affiliation":[{"name":"Directorate of Public Health and Environment Kampala Capital City Authority Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Sikorskii","sequence":"additional","affiliation":[{"name":"Department of Psychiatry College of Osteopathic Medicine Michigan State University East Lansing MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Tuke","sequence":"additional","affiliation":[{"name":"Department of Psychiatry College of Osteopathic Medicine Michigan State University East Lansing MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PM","family":"Musoke","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health School of Medicine College of Health Sciences Makerere University Kampala Uganda"},{"name":"Makerere University\u2010Johns Hopkins University Research Collaboration Kampala Uganda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Giordani","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry, Neurology, and Psychology University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"Boivin","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Neurology &amp; 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