{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:47:23Z","timestamp":1791964043932,"version":"4.3.4"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pediatr"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>HIV infection is associated with significant neurocognitive deficits making maximization of cognitive function among children receiving antiretroviral therapy (ART) a public health imperative. Non-protease inhibitors (non-PIs) achieve higher drug levels in the cerebral spinal fluid (CSF) compared to PIs, potentially leading to better neurocognitive function by reducing CSF viral load and inflammation. ART that maximises children\u2019s neurodevelopment and school achievement could result in improved quality of life and productivity as adults, but little research to date has examined whether non-PI ART is associated with better neurocognitive outcomes. We compared the neurocognitive function between children living with HIV receiving PI-based and non PI-based ART.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We recruited a consecutive sample of clinically stable Ugandan children living with HIV aged 5\u201312\u2009years who received PI-based or non PI-based ART for \u2265 1\u00a0year (viral load &lt;\u20091000 copies). Neurocognitive function was assessed using the Kaufman Assessment Battery for Children, the Test of Variables of Attention, and Bruininks-Oseretsky Test of Motor Proficiency. Age-adjusted neurocognitive z-scores for the two groups were compared using linear regression models in STATA version 13. The Hommel\u2019s method was used to adjust for multiple testing.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We enrolled 76 children living with HIV; 34 on PI ART and 42 on non-PI ART. Mean (\u00b1SD) age was greater in the non-PI vs. PI group (9.5\u2009\u00b1\u20091.9 vs. 8.5\u2009\u00b1\u20092.0) years (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Children in the non-PI group had lower socioeconomic scores (5.7\u2009\u00b1\u20093.3 vs. 7.4\u2009\u00b1\u20092.8, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). There was no difference in neurocognitive function between the groups (adjusted <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05) for KABC and TOVA. Children in the PI group had better total BOT scores than their counterparts (46.07\u2009\u00b1\u20091.40) vs. 40.51 (1.24), <jats:italic>p<\/jats:italic>\u2009=\u20090.03).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We detected no difference in neurocognitive function among children on PI and non PI-based ART therapy based on KABC and TOVA tests. Children on PI based ART had\u00a0better motor function than their counterparts. We recommend a prospective study with a larger sample size.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12887-021-02676-2","type":"journal-article","created":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T04:02:44Z","timestamp":1619409764000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Neurocognitive function among HIV-infected children on protease inhibitor -based versus non-protease inhibitor based antiretroviral therapy in Uganda: a pilot study"],"prefix":"10.1186","volume":"21","author":[{"given":"Damalie","family":"Nalwanga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Musiime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Bangirana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika Phelps","family":"Nishiguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Kiggwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Titus","family":"Ssesanga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Ssenkusu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippa","family":"Musoke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Cusick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"issue":"14","key":"2676_CR1","doi-asserted-by":"publisher","first-page":"1793","DOI":"10.1097\/QAD.0000000000000766","volume":"29","author":"J Hoare","year":"2015","unstructured":"Hoare J, Fouche JP, Phillips N, Joska JA, Paul R, Donald KA, et al. 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Ethical approval was obtained from the Joint Clinical Research Centre Ethics and Research Committee (JCRC-REC number JC 2518, University of Minnesota IRB (STUDY00004490) and Uganda National Council for Science and Technology (UNCST HS 2513). Written informed consent was obtained from the parent\/guardian and written assent was obtained from children 8\u2009years and older in order to participate in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author(s) declare that they have no competing interests","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"198"}}