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Huff HV, Sportiello K, Bearden DR. Central Nervous System Complications of HIV in Children. Curr HIV/AIDS Rep 2024; 21:40-51. [PMID: 38252368 DOI: 10.1007/s11904-024-00689-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Affiliation(s)
- Hanalise V Huff
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Building 10, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Kristen Sportiello
- Department of Neurology, Division of Child Neurology, University of Rochester Medical Center, 160 Elmwood Ave, Rochester, NY, 14618, USA
| | - David R Bearden
- Department of Educational Psychology, University of Zambia, Independence Ave, Lusaka, Zambia.
- Department of Neurology, Division of Child Neurology, University of Rochester Medical Center, 160 Elmwood Ave, Rochester, NY, 14618, USA.
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Nunes RH, Corrêa DG, Pacheco FT, Fonseca APA, Hygino da Cruz LC, da Rocha AJ. Neuroimaging of Infectious Vasculopathy. Neuroimaging Clin N Am 2024; 34:93-111. [PMID: 37951708 DOI: 10.1016/j.nic.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Vasculitis is a complication of several infectious diseases affecting the central nervous system, which may result in ischemic and/or hemorrhagic stroke, transient ischemic attack, and aneurysm formation. Infectious agents may directly infect the endothelium causing vasculitis or indirectly affect the vessel wall through an immunological cascade. Clinical manifestations usually overlap with those of noninfectious vascular diseases, making diagnosis challenging. Neuroimaging enables the identification of inflammatory changes in intracranial vasculitis. In this article, we review the imaging features of infectious vasculitis of bacterial, viral, fungal and parasitic causes.
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Affiliation(s)
- Renato Hoffmann Nunes
- Division of Neuroradiology, DASA - Diagnósticos da América SA, Rua João Cachoeira, 743, Itaim Bibi, 04535-012, Sao Paulo, Sao Paulo, Brazil.
| | - Diogo Goulart Corrêa
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, Barra da Tijuca, 2640-102, Rio de Janeiro, Rio de Janeiro, Brazil; Department of Radiology, Federal Fluminense University, Avenida Marquês de Paraná, 303, 24033-900, Niterói, Rio de Janeiro, Brazil
| | - Felipe Torres Pacheco
- Division of Neuroradiology, DASA - Diagnósticos da América SA, Rua João Cachoeira, 743, Itaim Bibi, 04535-012, Sao Paulo, Sao Paulo, Brazil; Division of Neuroradiology, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesário Mota Júnior, 112, Vila Buarque, 01221-020, Sao Paulo, Sao Paulo, Brazil. https://twitter.com/ofelipe_pacheco
| | - Ana Paula Alves Fonseca
- Division of Neuroradiology, DASA - Diagnósticos da América SA, Rua João Cachoeira, 743, Itaim Bibi, 04535-012, Sao Paulo, Sao Paulo, Brazil
| | - Luiz Celso Hygino da Cruz
- Department of Radiology, Clínica de Diagnóstico por Imagem (CDPI)/DASA, Avenida das Américas, 4666, Barra da Tijuca, 2640-102, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Antônio José da Rocha
- Division of Neuroradiology, DASA - Diagnósticos da América SA, Rua João Cachoeira, 743, Itaim Bibi, 04535-012, Sao Paulo, Sao Paulo, Brazil; Division of Neuroradiology, Santa Casa de Sao Paulo School of Medical Sciences, Rua Dr. Cesário Mota Júnior, 112, Vila Buarque, 01221-020, Sao Paulo, Sao Paulo, Brazil
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Kabundula PP, Mbewe EG, Mwanza-Kabaghe S, Birbeck GL, Mweemba M, Wang B, Menon JA, Bearden DR, Adams HR. Validation of the National Institute of Health Toolbox Cognition Battery (NIHTB-CB) in Children and Adolescents with and without HIV Infection in Lusaka, Zambia. AIDS Behav 2022; 26:3436-3449. [PMID: 35445991 PMCID: PMC10310430 DOI: 10.1007/s10461-022-03669-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/01/2022]
Abstract
The objective of this study was to validate the NIH Toolbox Cognition Battery (NIHTB-CB) in Zambian children with and without HIV-infection. Children living with HIV and HIV-exposed, uninfected (HEU) children completed traditional neuropsychological and NIHTB-CB tasks. Using pairwise correlation and a linear regression model we measured associations between traditional measure composite scores and parental ratings of children's abilities, and NIHTB-CB scores. A Receiver Operating Characteristic (ROC) curve was developed to identify participants with impairment. 389 children, 8-17 years old participated. NIHTB-CB and traditional measures converged well as a whole and when comparing analogous individual tests across the two batteries. The NIHTB-CB composite score discriminated between the groups and was positively associated with external criteria for cognitive function: parental ratings of intelligence and school performance. Some English vocabulary and/or an unfamiliar cultural context presented challenges. NIHTB-CB was associated with children's everyday cognitive abilities, though future use may require linguistic and cultural adaptation.
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Affiliation(s)
| | - Esau G Mbewe
- Department of Educational Psychology, University of Zambia, Lusaka, Zambia
| | - Sylvia Mwanza-Kabaghe
- Department of Educational Psychology, University of Zambia, Lusaka, Zambia
- University Teaching Hospital, Neurology Research Office, Lusaka, Zambia
| | - Gretchen L Birbeck
- University Teaching Hospital, Neurology Research Office, Lusaka, Zambia
- University of Zambia School of Medicine, Lusaka, Zambia
- Division of Epilepsy, University of Rochester Medical Center Department of Neurology, Rochester, NY, USA
| | - Milimo Mweemba
- Department of Educational Psychology, University of Zambia, Lusaka, Zambia
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - J Anitha Menon
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - David R Bearden
- Division of Child Neurology, University of Rochester Medical Center Department of Neurology, Rochester, NY, USA
| | - Heather R Adams
- Division of Child Neurology, University of Rochester Medical Center Department of Neurology, Rochester, NY, USA.
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Mbewe EG, Kabundula PP, Mwanza-Kabaghe S, Buda A, Adams HR, Schneider C, Potchen MJ, Mweemba M, Mathews M, Menon JA, Wang B, Baseler T, Paciorkowski A, Birbeck GL, Bearden DR. Socioeconomic Status and Cognitive Function in Children With HIV: Evidence From the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) Study. J Acquir Immune Defic Syndr 2022; 89:56-63. [PMID: 34878435 PMCID: PMC8794014 DOI: 10.1097/qai.0000000000002825] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/20/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Multiple previous studies have identified a detrimental effect of pediatric HIV on cognitive function. Socioeconomic status (SES) is one of the strongest predictors of cognitive performance and may affect the relationship between HIV and cognition. METHODS As part of the ongoing HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) study, a prospective cohort study, we recruited 208 participants with HIV and 208 HIV-exposed uninfected controls, all aged 8-17 years. A standardized questionnaire was administered to assess SES, and all participants had comprehensive neuropsychological testing. An NPZ8 score was derived as a summary measure of cognitive function. Logistic regression and linear regression were used to model the relationship between SES and cognitive function, and mediation analysis was used to identify specific pathways by which SES may affect cognition. RESULTS Children with HIV performed significantly worse on a composite measure of cognitive function (NPZ8 score -0.19 vs. 0.22, P < 0.001) and were more likely to have cognitive impairment (33% vs. 19%, P = 0.001). Higher SES was associated with reduced risk of cognitive impairment (odds ratio 0.8, 95% confidence interval: 0.75-0.92, P < 0.001) in both groups, with similar effects in children with HIV and HIV-exposed uninfected groups. SES was more strongly correlated with NPZ8 score in children with HIV than in uninfected controls (Pearson's R 0.39 vs. 0.28), but predicted NPZ8 in both groups. Mediation analysis suggested that the effect of SES on cognition was most strongly mediated through malnutrition. CONCLUSIONS Cognitive function is strongly correlated with SES in children with HIV, suggesting a synergistic effect of HIV and poverty on cognitive function.
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Affiliation(s)
- Esau G Mbewe
- Department of Educational Psychology, University of Zambia, Lusaka, Zambia
| | | | | | - Alexandra Buda
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Heather R Adams
- University of Rochester School of Medicine and Dentistry, Rochester, NY
- Division of Child Neurology, Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Colleen Schneider
- University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Michael J Potchen
- Department of Imaging Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY
- Lusaka Apex Medical University, Lusaka, Zambia
| | - Milimo Mweemba
- University Teaching Hospital, Neurology Research Office, Lusaka, Zambia
| | - Manoj Mathews
- University Teaching Hospital, Neurology Research Office, Lusaka, Zambia
- University Teaching Hospital Children's Hospital, Lusaka, Zambia
- Directorate of Clinical Care and Diagnostics Services, Ministry of Health, Lusaka, Zambia
| | - J Anitha Menon
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Travis Baseler
- Department of Economics, University of Rochester, Rochester, NY
| | - Alex Paciorkowski
- Division of Child Neurology, Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Gretchen L Birbeck
- University Teaching Hospital, Neurology Research Office, Lusaka, Zambia
- University of Zambia School of Medicine, Lusaka, Zambia ; and
- Division of Epilepsy, Department of Neurology, Rochester, NY
| | - David R Bearden
- University of Rochester School of Medicine and Dentistry, Rochester, NY
- Division of Child Neurology, Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, NY
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