Early HIV Treatment With Antiretrovirals Unlikely to Impair Cognitive Development in Children, Study Finds

Kim LaCapria

A study out of Thailand examining the neurological impact of the use of HIV treatment drugs on small children seems to indicate that use of medication including antiretrovirals is unlikely to cause cognitive impairment, even when started at a young age.

Deputy director for scientific affairs for the HIV Netherlands Australia Thailand (HIV-NAT) collaboration in Bangkok Jintanat Ananworanich, MD, said that "IQ scores at week 144 averaged 75 for HIV-infected children who underwent immediate antiretroviral therapy; those who were not treated with HIV-suppressant therapy until CD4-positive cell counts dropped had an average score of 74, not a significant difference," noted in MedPageToday's review of the recent study. The study- which has not yet been peer reviewed- lasted 144 weeks in total and followed 280 HIV-positive children in Bangkok.

Children in the study had a median age of 9, and given the data found among children who had been treated early on versus those who had not, Ananworanich said researchers theorized that the damage done to the developing brain by HIV is likely to pose more of a risk to cognitive development than the drugs used to treat it:

"Poorer performance on neurodevelopmental testing among HIV-positive children may be related to early HIV insult to the brain," she suggested. "The optimal window of opportunity in antiretroviral initiation remains early in infancy."
"We know that this virus likes the brain and we know that the baby brain is very vulnerable to the virus. In these groups the children are starting therapy later and perhaps the damage to the brain has already been done before they even got to the benefit of antiretroviral treatment."