{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:12:01Z","timestamp":1785499921804,"version":"3.56.0"},"reference-count":55,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,12,1]]},"abstract":"<jats:sec><jats:title>Background.<\/jats:title><jats:p>Neuropsychological testing and 2 measures of neurological status, cortical atrophy, and motor dysfunction were assessed for their usefulness in predicting human immunodeficiency virus (HIV) disease progression in infants, children, and adolescents who participated in Pediatric AIDS Clinical Trials Group Protocol 152 (PACTG 152).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>A cohort of 722 antiretroviral therapy-naive children with symptomatic HIV infection were assessed at study entry and at later intervals. Assessments included neurodevelopmental testing, neuroradiologic imaging, and neurological examination of motor function. CD4 cell count and plasma RNA viral load also were measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Children with the lowest neuropsychological functioning (IQ &amp;lt; 70) at baseline had the highest risk for later HIV disease progression (56%), compared with those with borderline\/low (IQ = 70\u201389) functioning (26%), or with average or above (IQ &amp;gt; 90) functioning (18%). This was also true of week 48 neuropsychological functioning. Motor dysfunction (especially reduced muscle mass) at entry also predicted disease progression. Furthermore, motor dysfunction and week 48 neuropsychological functioning provided predictive information beyond that obtainable from surrogate markers of HIV disease status (eg, CD4 count, HIV RNA level). Children with cortical atrophy also were at higher risk for later disease progression, but when CD4 count and RNA viral load were known, cortical atrophy information provided no additional predictive information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions.<\/jats:title><jats:p>Measures of neuropsychological and motor function status provide unique information regarding pediatric HIV disease progression. As such, these findings have important implications for predicting long-term outcomes (eg, longevity) in pediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.106.6.e76","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:50:41Z","timestamp":1092441041000},"page":"e76-e76","source":"Crossref","is-referenced-by-count":44,"title":["Predicting HIV Disease Progression in Children Using Measures of Neuropsychological and Neurological Functioning"],"prefix":"10.1542","volume":"106","author":[{"given":"Deborah A.","family":"Pearson","sequence":"first","affiliation":[{"name":"From the Department of Psychiatry and Behavioral Sciences, University of Texas-Houston Medical School, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuala M.","family":"McGrath","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard School of Public Health, Cambridge, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Nozyce","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Bronx Lebanon Hospital Center, Bronx, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Nichols","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, University of California, San Diego, San Diego, California; and the Departments of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Raskino","sequence":"additional","affiliation":[{"name":"Center for Biostatistics in AIDS Research, Harvard School of Public Health, Cambridge, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim","family":"Brouwers","sequence":"additional","affiliation":[{"name":"Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta C.","family":"Lifschitz","sequence":"additional","affiliation":[{"name":"Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol J.","family":"Baker","sequence":"additional","affiliation":[{"name":"Pediatrics and"},{"name":"Microbiology and Immunology, Baylor College of Medicine, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet A.","family":"Englund","sequence":"additional","affiliation":[{"name":"Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Pediatric AIDS Clinical Trials 152 Study Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,12,1]]},"reference":[{"key":"2021121003302018800_B1"},{"key":"2021121003302018800_B2","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1111\/j.1469-8749.1990.tb08123.x","article-title":"Effects of congenital HIV infection on neurodevelopmental status of babies in foster care.","volume":"32","author":"Diamond","year":"1990","journal-title":"Dev Med Child Neurol"},{"key":"2021121003302018800_B3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1177\/088307389300800212","article-title":"Pediatric AIDS: a longitudinal comparative MRI and CT brain imaging study.","volume":"8","author":"Chamberlain","year":"1993","journal-title":"J Child Neurol"},{"key":"2021121003302018800_B4","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1111\/j.1651-2227.1994.tb13337.x","article-title":"Pediatric HIV infection: neurologic and neuropsychologic findings.","volume":"400","author":"Fowler","year":"1994","journal-title":"Acta Paediatr Suppl"},{"key":"2021121003302018800_B5","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1001\/archneur.1995.00540250043011","article-title":"Correlation between computed tomographic brain scan abnormalities and neuropsychological function in children with symptomatic human immunodeficiency virus disease.","volume":"52","author":"Brouwers","year":"1995","journal-title":"Arch Neurol"},{"key":"2021121003302018800_B6","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1097\/00002030-199507000-00008","article-title":"Relation between stage of disease and neurobehavioral measures in children with symptomatic HIV disease.","volume":"9","author":"Brouwers","year":"1995","journal-title":"AIDS"},{"key":"2021121003302018800_B7","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/09297049508402241","article-title":"White matter changes on CT brain scan are associated with neurobehavioral dysfunction in children with symptomatic HIV disease.","volume":"1","author":"Brouwers","year":"1995","journal-title":"Child Neuropsychol"},{"key":"2021121003302018800_B8","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1017\/S0317167100038804","article-title":"A novel approach to the determination and characterization of HIV dementia.","volume":"23","author":"Brouwers","year":"1996","journal-title":"Can J Neurol Sci"},{"key":"2021121003302018800_B9","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1093\/jpepsy\/21.3.379","article-title":"Impairment of expressive behavior in pediatric HIV-infected patients with evidence of CNS disease.","volume":"21","author":"Moss","year":"1996","journal-title":"J Pediatr Psychol"},{"key":"2021121003302018800_B10","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1542\/peds.91.4.742","article-title":"Effects of human immunodeficiency virus and immune status on magnetic resonance imaging of the brain in hemophilic subjects: results from the Hemophilia Growth and Development Study.","volume":"91","author":"Mitchell","year":"1993","journal-title":"Pediatrics"},{"key":"2021121003302018800_B11","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1093\/infdis\/171.4.837","article-title":"Multivariate models for predicting progression to AIDS and survival in human immunodeficiency virus-infected persons.","volume":"171","author":"Blatt","year":"1995","journal-title":"J Infect Dis"},{"key":"2021121003302018800_B12","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1097\/00006454-199610000-00012","article-title":"Prospective study of human immunodeficiency virus 1-related disease among 512 infants born to infected women in New York City. The New York Perinatal HIV Transmission Collaborative Study Group.","volume":"15","author":"Bamji","year":"1996","journal-title":"Pediatr Infect Dis J"},{"key":"2021121003302018800_B13","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/00002030-199607000-00009","article-title":"HIV-1 RNA levels and the development of clinical disease. North American Lamivudine HIV Working Group.","volume":"10","author":"Phillips","year":"1996","journal-title":"AIDS"},{"key":"2021121003302018800_B14","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/00042560-199608010-00010","article-title":"Analysis of an HIV-infected cohort followed for as long as 15 years after seroconversion.","volume":"12","author":"Vallely","year":"1996","journal-title":"J Acquir Immune Defic Syndr Hum Retrovirol"},{"key":"2021121003302018800_B15","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1097\/00002030-199712000-00012","article-title":"Increased losses of CD4+CD45RA+ cells in late stages of HIV infection is related to increased risk of death: evidence from a cohort of 347 HIV-infected individuals.","volume":"11","author":"Ullum","year":"1997","journal-title":"AIDS"},{"key":"2021121003302018800_B16","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1097\/00042560-199808010-00006","article-title":"Are there clinical and laboratory predictors of 5-year mortality in HIV-infected children and adolescents with hemophilia?","volume":"18","author":"Hoots","year":"1998","journal-title":"J Acquir Immune Defic Syndr Hum Retrovirol"},{"key":"2021121003302018800_B17","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1001\/jama.279.10.756","article-title":"Predictive value of quantitative plasma HIV RNA and CD4+ lymphocyte count in HIV-infected infants and children.","volume":"279","author":"Palumbo","year":"1998","journal-title":"JAMA"},{"key":"2021121003302018800_B18","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1111\/j.1469-8749.1985.tb14127.x","article-title":"Developmental abnormalities in infants and children with acquired immune deficiency syndrome (AIDS) and AIDS-related complex.","volume":"27","author":"Ultmann","year":"1985","journal-title":"Dev Med Child Neurol"},{"key":"2021121003302018800_B19","doi-asserted-by":"crossref","first-page":"661","DOI":"10.3109\/00207458709043320","article-title":"Developmental abnormalities in children with acquired immunodeficiency syndrome (AIDS): a follow-up study.","volume":"32","author":"Ultmann","year":"1987","journal-title":"Int J Neurosci"},{"key":"2021121003302018800_B20","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/00002030-199405000-00009","article-title":"A 12-month study of the effects of oral zidovudine on neurodevelopmental functioning in a cohort of vertically HIV-infected inner-city children.","volume":"8","author":"Nozyce","year":"1994","journal-title":"AIDS"},{"key":"2021121003302018800_B21","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S0733-8627(20)30376-X","article-title":"HIV infections in children.","volume":"13","author":"Walker","year":"1995","journal-title":"Emerg Med Clin North Am"},{"key":"2021121003302018800_B22","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1016\/S0140-6736(96)91073-9","article-title":"Importance of age at infection with HIV-1 for survival and development of AIDS in UK haemophilia population. UK Haemophilia Centre Director's Organisation.","volume":"347","author":"Darby","year":"1996","journal-title":"Lancet"},{"key":"2021121003302018800_B23","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/00042560-199809010-00014","article-title":"Determinants of progression of HIV infection in a Greek hemophilia cohort followed for up to 16 years after seroconversion.","volume":"19","author":"Touloumi","year":"1998","journal-title":"J Acquir Immune Defic Syndr Hum Retrovirol"},{"key":"2021121003302018800_B24","first-page":"218","article-title":"Cognitive and motor development in infants at risk for human immunodeficiency virus.","volume":"146","author":"Aylward","year":"1992","journal-title":"Am J Dis Child"},{"key":"2021121003302018800_B25","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1002\/ana.410230709","article-title":"Neurological and neuropathological features of human immunodeficiency virus infection in children.","volume":"23","author":"Epstein","year":"1988","journal-title":"Ann Neurol"},{"key":"2021121003302018800_B26","first-page":"80","article-title":"Children and AIDS.","volume":"104","author":"Olofsson","year":"1989","journal-title":"Nord Med"},{"key":"2021121003302018800_B27"},{"key":"2021121003302018800_B28","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1037\/0278-6133.14.1.13","article-title":"A preliminary evaluation of the cognitive and motor effects of pediatric HIV infection in Zairian children.","volume":"14","author":"Boiven","year":"1995","journal-title":"Health Psychol"},{"key":"2021121003302018800_B29","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1001\/archpedi.1995.02170210024004","article-title":"Early neurodevelopmental growth in children with vertically transmitted human immunodeficiency virus infection.","volume":"149","author":"Chase","year":"1995","journal-title":"Arch Pediatr Adolesc Med"},{"key":"2021121003302018800_B30","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1126\/science.3277272","article-title":"The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex.","volume":"239","author":"Price","year":"1988","journal-title":"Science"},{"key":"2021121003302018800_B31"},{"key":"2021121003302018800_B32","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1542\/peds.92.6.843","article-title":"Neurodevelopmental testing of children born to human immunodeficiency virus type 1 seropositive and seronegative mothers: a prospective cohort study in Kigali, Rwanda.","volume":"92","author":"Msellati","year":"1993","journal-title":"Pediatrics"},{"key":"2021121003302018800_B33"},{"key":"2021121003302018800_B34","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1542\/peds.88.1.58","article-title":"Neuropsychological functioning in human immunodeficiency virus type 1 seropositive children infected through neonatal blood transfusions.","volume":"88","author":"Cohen","year":"1991","journal-title":"Pediatrics"},{"key":"2021121003302018800_B35","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/S0022-3476(05)83486-9","article-title":"Neuropsychologic functioning of human immunodeficiency virus-infected children with hemophilia.","volume":"122","author":"Whitt","year":"1993","journal-title":"J Pediatr"},{"key":"2021121003302018800_B36","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1093\/jpepsy\/19.2.223","article-title":"Hemophilia growth and development study: baseline neurodevelopmental findings.","volume":"19","author":"Loveland","year":"1994","journal-title":"J Pediatr Psychol"},{"key":"2021121003302018800_B37","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/jpepsy\/23.1.45","article-title":"Hemophilia growth and development study: relationships between neuropsychological, neurological, and MRI findings at baseline.","volume":"23","author":"Sirois","year":"1998","journal-title":"J Pediatr Psychol"},{"key":"2021121003302018800_B38","first-page":"358","article-title":"Possible neuropsychological deficits in infants with acquired immunodeficiency syndrome.","volume":"24","author":"Coulter","year":"1988","journal-title":"Ann Neurol"},{"key":"2021121003302018800_B39","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3109\/13550289609146906","article-title":"Psychomotor slowing in HIV infection: a predictor of dementia, AIDS, and death.","volume":"2","author":"Sacktor","year":"1996","journal-title":"J Neurovirol"},{"key":"2021121003302018800_B40","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1097\/00002030-199709000-00009","article-title":"Receptive and expressive language function of children with symptomatic HIV infection and relationship with disease parameters: a longitudinal 24-month follow-up study.","volume":"11","author":"Wolters","year":"1997","journal-title":"AIDS"},{"key":"2021121003302018800_B41"},{"key":"2021121003302018800_B42","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1037\/h0088312","article-title":"Pediatric HIV disease: effect on cognition, learning, and behavior.","volume":"10","author":"Wolters","year":"1995","journal-title":"Sch Psychol Q"},{"key":"2021121003302018800_B43"},{"key":"2021121003302018800_B44","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1056\/NEJM199706123362403","article-title":"Zidovudine, didanosine, or both as the initial treatment for symptomatic HIV-infected children.","volume":"336","author":"Englund","year":"1997","journal-title":"N Engl J Med"},{"key":"2021121003302018800_B45","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1097\/00006454-199611000-00018","article-title":"Clinical and laboratory characteristics of a large cohort of symptomatic, HIV-infected infants and children.","volume":"15","author":"Englund","year":"1996","journal-title":"Pediatr Infect Dis J"},{"key":"2021121003302018800_B46"},{"key":"2021121003302018800_B47"},{"key":"2021121003302018800_B48"},{"key":"2021121003302018800_B49"},{"key":"2021121003302018800_B50"},{"key":"2021121003302018800_B51","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1093\/infdis\/173.5.1097","article-title":"Randomized study of the tolerance and efficacy of high- versus low-dose zidovudine in human immunodeficiency virus-infected children with mild to moderate symptoms (AIDS Clinical Trials Group 128).","volume":"173","author":"Brady","year":"1996","journal-title":"J Infect Dis"},{"key":"2021121003302018800_B52"},{"key":"2021121003302018800_B53","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1097\/00002030-199807000-00012","article-title":"Incubation period of HIV-1 in perinatally infected children. New York City Perinatal HIV Transmission Collaborative Study Group.","volume":"12","author":"Pliner","year":"1998","journal-title":"AIDS"},{"key":"2021121003302018800_B54"},{"key":"2021121003302018800_B55"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/6\/e76\/892814\/e76.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/6\/e76\/892814\/e76.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T07:33:09Z","timestamp":1734507189000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/106\/6\/e76\/63177\/Predicting-HIV-Disease-Progression-in-Children"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12,1]]},"references-count":55,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2000,12,1]]},"published-print":{"date-parts":[[2000,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.106.6.e76","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2000,12,1]]}}}