[ABSTRAK
Latar belakang: Pasien HIV anak berisiko tinggi mengalami gangguanneurokognitif akibat keterlibatan sistem saraf pusat (SSP). Prevalens gangguankognitif tersebut berkisar antara 8%-62%. Pemberian ARV menurunkan viralload di SSP sehingga mencegah penurunan fungsi kognitif. Tujuan penelitian iniuntuk memberikan gambaran fungsi kognitif pasien HIV anak dalam terapi ARV.Metode: Studi potong lintang dilakukan terhadap pasien HIV anak berusia 5-15tahun. Penilaian kognitif dilakukan dengan instrumen Wechsler intelligence scalefor children IV (WISC IV). Pemeriksaan elektroensefalografi bertujuan untukmembuktikan kerusakan akibat keterlibatan SSP pada infeksi HIV.Hasil: Sembilan puluh pasien HIV anak median usia 9 tahun telah memperolehARV dengan median 69 bulan. Hasil rerata verbal, performance, dan full-scale IQ(FSIQ) berturut-turut adalah 88,66 (SB 15,69), 85,30 (SB 15,35), dan 85,73 (SB15,61). Enam puluh tujuh (74,4%) subjek memiliki verbal IQ normal, 56 (62,2%)performance scale normal, dan 58 (64,4%) FSIQ normal. Hasil EEG abnormaldidapatkan pada 22 subjek (22,4%) dan tidak memiliki hubungan dengan stadiumklinis, usia dan lama pemberian ARV, serta viral load. Stadium HIVmenunjukkan hubungan bermakna dengan komponen verbal scale IQ dan FSIQ(p=0,042 dan p=0,044). Hasil IQ tidak memiliki hubungan dengan usia pemberianARV, lama pemberian ARV, dan viral load.Simpulan: Pasien HIV anak dalam terapi ARV memiliki rerata IQ abnormal padaverbal, performance, dan FSIQ. Berdasarkan kategori hasil IQ lebih dari 50%subjek memiliki IQ normal pada ketiga skala WISC. Studi kohort diperlukanuntuk menilai apakah pemberian ARV lebih dini dan faktor yang memengaruhidapat mencegah penurunan fungsi kognitif pasien HIV anakABSTRACT Introduction: Children with HIV infection are at high risk for developingneurocognitive impairment because of central nervous system (CNS)involvement. Prevalence of cognitive impairment is reported between 8%-62%.Decreased viral load due to antiretroviral therapy (ARV) would prevent thedecrease of cognitive function. The aim of this study was to describe cognitivefunction in HIV-infected children on ARV.Method: We conducted cross sectional study of HIV-infected children aged 5-15years. Wechsler intelligence scale for children IV (WISC-IV) was administeredfor assessing cognitive function. Electroencephalograph was performed to proveabnormalities caused by CNS involvement of HIV infectionResults: Ninety HIV-infected children with median age of 9 years had receivedARV for median of 69 months. The mean (SD) of verbal, performance, and fullscale IQ were 88,66 (SD 15,69), 85,30 (SD 15,35), and 85,73 (SD 15,61)respectively. Sixty seven subjects (74,4%) had normal verbal IQ, 56 subjects(62,2%) had normal performance IQ, and 58 subjects (64,4%) had normal FSIQ.Twenty two children (22,4%) showed EEG abnormality which was not correlatedto clinical stage, onset and duration of ARV, and viral load. Clinical stage of HIVshowed significant association with verbal and FSIQ (p 0,042 and p 0,044). IQresults did not have association with onset and duration of ARV and viral load.Conclusion: HIV-infected children on ARV have abnormal mean IQ in verbal,performance and FSIQ. Based on categorical IQ, most subjects have normalverbal, performance, and FSIQ. Cohort study is needed to address whether earlyARV can preserve cognitive function.;Introduction: Children with HIV infection are at high risk for developingneurocognitive impairment because of central nervous system (CNS)involvement. Prevalence of cognitive impairment is reported between 8%-62%.Decreased viral load due to antiretroviral therapy (ARV) would prevent thedecrease of cognitive function. The aim of this study was to describe cognitivefunction in HIV-infected children on ARV.Method: We conducted cross sectional study of HIV-infected children aged 5-15years. Wechsler intelligence scale for children IV (WISC-IV) was administeredfor assessing cognitive function. Electroencephalograph was performed to proveabnormalities caused by CNS involvement of HIV infectionResults: Ninety HIV-infected children with median age of 9 years had receivedARV for median of 69 months. The mean (SD) of verbal, performance, and fullscale IQ were 88,66 (SD 15,69), 85,30 (SD 15,35), and 85,73 (SD 15,61)respectively. Sixty seven subjects (74,4%) had normal verbal IQ, 56 subjects(62,2%) had normal performance IQ, and 58 subjects (64,4%) had normal FSIQ.Twenty two children (22,4%) showed EEG abnormality which was not correlatedto clinical stage, onset and duration of ARV, and viral load. Clinical stage of HIVshowed significant association with verbal and FSIQ (p 0,042 and p 0,044). IQresults did not have association with onset and duration of ARV and viral load.Conclusion: HIV-infected children on ARV have abnormal mean IQ in verbal,performance and FSIQ. Based on categorical IQ, most subjects have normalverbal, performance, and FSIQ. Cohort study is needed to address whether earlyARV can preserve cognitive function.;Introduction: Children with HIV infection are at high risk for developingneurocognitive impairment because of central nervous system (CNS)involvement. Prevalence of cognitive impairment is reported between 8%-62%.Decreased viral load due to antiretroviral therapy (ARV) would prevent thedecrease of cognitive function. The aim of this study was to describe cognitivefunction in HIV-infected children on ARV.Method: We conducted cross sectional study of HIV-infected children aged 5-15years. Wechsler intelligence scale for children IV (WISC-IV) was administeredfor assessing cognitive function. Electroencephalograph was performed to proveabnormalities caused by CNS involvement of HIV infectionResults: Ninety HIV-infected children with median age of 9 years had receivedARV for median of 69 months. The mean (SD) of verbal, performance, and fullscale IQ were 88,66 (SD 15,69), 85,30 (SD 15,35), and 85,73 (SD 15,61)respectively. Sixty seven subjects (74,4%) had normal verbal IQ, 56 subjects(62,2%) had normal performance IQ, and 58 subjects (64,4%) had normal FSIQ.Twenty two children (22,4%) showed EEG abnormality which was not correlatedto clinical stage, onset and duration of ARV, and viral load. Clinical stage of HIVshowed significant association with verbal and FSIQ (p 0,042 and p 0,044). IQresults did not have association with onset and duration of ARV and viral load.Conclusion: HIV-infected children on ARV have abnormal mean IQ in verbal,performance and FSIQ. Based on categorical IQ, most subjects have normalverbal, performance, and FSIQ. Cohort study is needed to address whether earlyARV can preserve cognitive function., Introduction: Children with HIV infection are at high risk for developingneurocognitive impairment because of central nervous system (CNS)involvement. Prevalence of cognitive impairment is reported between 8%-62%.Decreased viral load due to antiretroviral therapy (ARV) would prevent thedecrease of cognitive function. The aim of this study was to describe cognitivefunction in HIV-infected children on ARV.Method: We conducted cross sectional study of HIV-infected children aged 5-15years. Wechsler intelligence scale for children IV (WISC-IV) was administeredfor assessing cognitive function. Electroencephalograph was performed to proveabnormalities caused by CNS involvement of HIV infectionResults: Ninety HIV-infected children with median age of 9 years had receivedARV for median of 69 months. The mean (SD) of verbal, performance, and fullscale IQ were 88,66 (SD 15,69), 85,30 (SD 15,35), and 85,73 (SD 15,61)respectively. Sixty seven subjects (74,4%) had normal verbal IQ, 56 subjects(62,2%) had normal performance IQ, and 58 subjects (64,4%) had normal FSIQ.Twenty two children (22,4%) showed EEG abnormality which was not correlatedto clinical stage, onset and duration of ARV, and viral load. Clinical stage of HIVshowed significant association with verbal and FSIQ (p 0,042 and p 0,044). IQresults did not have association with onset and duration of ARV and viral load.Conclusion: HIV-infected children on ARV have abnormal mean IQ in verbal,performance and FSIQ. Based on categorical IQ, most subjects have normalverbal, performance, and FSIQ. Cohort study is needed to address whether earlyARV can preserve cognitive function.] |
T-Herlina.pdf :: Unduh