Neurologische en cognitieve ontwikkeling bij kinderen die vanaf de geboorte hiv geïnfecteerd zijn

Despite combination antiretroviral therapy (cART), perinatally HIV (PHIV)-infected children present with significant neurodevelopmental delays and cognitive impairments. The pathogenesis may partially differ from that in adults, as HIV does not only cause direct injury to the CNS, but may also impede the development of the pediatric brain. As we have recently shown, manifestations of HIV in the pediatric central nervous system (CNS) include brain volume reduction and white matter lesions, as well as widespread microstructural changes, such as poorer white matter integrity and alterations in cerebral metabolites. Evidence implies significant roles for ongoing neuroinflammation, vascular dysfunction and hypercoagulability. Investigations combining neuropsychological assessment, multimodal neuroimaging and laboratory evaluation of inflammatory and neurodegenerative markers could greatly increase our understanding and improve treatment strategies. Longitudinal research will be crucial to observe and understand mechanisms underlying these long-term consequences of CNS exposure to HIV and cART as PHIV-infected survive into adulthood. In this study we will evaluate neurological and cognitive outcomes in a case-control cohort of PHIV infected children and sex, ethnicity and socioeconomic status matched healthy controls at an interval period of four years. We will investigate potential mechanisms and factors (such as inflammatory and neuronal biomarkers) that may influence these CNS functions.

Second measurement after 4-5 years. These measurements are cross sectional.

None