Relationship between cognitive and immune functioning in children born to HIV‐1 seropositive women

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Abstract
This study examined the relative contributions of immune system dysfunction, HIV type 1 (HIV‐1) serostatus, and psychosocial and environmental cofactors to cognitive functioning in children (N=46), ages 1 year 3 months to 9 years 3 months. All children were born to HIV‐1 seropositive women; children's cord blood at birth was positive for HIV‐1 antibodies. However, subsequent testing for HIV‐1 antibodies at age 1 year 3 months revealed that 54% of the sample were HIV‐1 infected while 46%, although exposed to HIV‐1 in utero, were uninfected. Children were administered the Bayley Scales of Infant Development or McCarthy Scales of Children's Abilities to assess level of overall cognitive functioning. Immune system dysfunction was indexed by the percent of CD4+ cells proximal to time of cognitive testing. Psychosocial and environmental cofactors included offspring demographic characteristics (age, gender, ethnicity), caregiver status, and maternal drug use during pregnancy. Multiple hierarchical regression analysis was used to determine the extent to which the degree of immune system dysfunction was related to the level of cognitive functioning while controlling for the effects of psychosocial and environmental cofactors and offspring HIV‐1 serostatus. Results suggest that the magnitude of HIV‐1‐related immunosuppression is a unique and significant predictor of cognitive functioning above and beyond psychosocial and environmental cofactors. Furthermore, our findings support the notion that the degree of immune system dysfunction is related to the level of cognitive functioning in children born to HIV‐1 seropositive women, despite the child's HIV‐1 serostatus.