HIV Drugs Not Linked with Child Psychiatric Problems

Antiretroviral therapy does not appear to increase the risk of psychiatric problems in children with HIV, a new study suggests. Scientists have been worried about high rates of psychiatric and academic problems in children with HIV.

“The question that is coming up is, ‘Why do they have so many issues? Is it their HIV, is it their antiretrovirals or is it other factors?’” said study author Dr. Sharon Nachman of Stony Brook University in New York.

In an earlier study, Nachman and colleagues found that children with HIV and those with an HIV-positive family member had similarly high rates of psychiatric problems, suggesting environmental stressors. The new study analyzed data on 319 HIV-infected children and adolescents ages six to 17 enrolled in the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group study in the United States and Puerto Rico.

One-third of the children had at least one psychiatric disorder, such as depression or attention-deficit hyperactivity disorder (ADHD). However, no link was found between antiretroviral therapy and any psychiatric problem.

“It wasn’t the antiretrovirals,” Nachman said. “It didn’t matter which antiretrovirals the kids used. Those didn’t predict or prevent a kid from getting a psychiatric illness” or having social or academic problems, she said.

In looking at markers of the severity of the disease, such as CD4 cell levels and viral loads, the results were mixed. Children with a lower CD4 percentage at baseline had less severe depression. Those with high viral loads at baseline had more severe depression. Children with the most severe disease at baseline did worse on cognitive tests of executive functioning, such as remembering a sequence of numbers, Nachman said.

“It appears if you had a high viral load at a younger age or a low CD4 percentage, you did get a hit on your brain” in terms of executive function, Nachman said. The study did not prove cause and effect, but it suggests HIV infection could affect the brain, she said.

The full report, “Human Immunodeficiency Virus Disease Severity, Psychiatric Symptoms, and Functional Outcomes in Perinatally Infected Youth,” was published online in Archives of Pediatrics & Adolescent Medicine (2012;doi:10.1001/archpediatrics.2011.1785).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.

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