Memory Functioning in Children and Adolescents with Perinatal HIV Infection

围产期艾滋病毒感染儿童和青少年的记忆功能

基本信息

批准号：
8006434
负责人：
SHARON L NICHOLS
金额：
$ 38.97万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-18 至 2014-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8006434
关键词：
AIDS neuropathy AIDS/HIV problem Academic achievement Adaptive Behaviors Adherence Adolescence Adolescent Adult Affect Age Anti-Retroviral Agents Area Attention Behavior Behavioral Birth Brain Caregivers Caring Centers for Disease Control and Prevention (U.S.)Child Childhood Chronic Disease Clinical Sciences Cognitive Cohort Studies Communities Complex Data Development Diagnosis Disease Disease Marker Failure Future Generations Goals HIV HIV Infections HIV-1 Health Healthcare Impairment Infection Intention Intervention Investigation Knowledge Language Learning Life Literature Longevity Longitudinal Studies Measures Medical Medication Management Memory Mosses Neuraxis Neurocognitive Occupational Outcome Parents Pattern Performance Perinatal Perinatal Infection Persons Pharmaceutical Preparations Population Problem Solving Protocols documentation Provider Public Health Quality of life Reading Recording of previous events Relative (related person)Research Research Design Resistance Resources Risk Sampling Self Care Severities Severity of illness Short-Term Memory Site Task Performances Testing Time Underserved Population Viral Virus Youth advanced disease base coping cost effective daily functioning design economic implication effective intervention executive function falls flexibility functional outcomes health economics improved functioning insight longitudinal design medication compliance meetings neuropathology pediatric human immunodeficiency virus infection peer physical conditioning prospective memory skills social social skills therapy development tool young adult

项目摘要

DESCRIPTION (provided by applicant): Current treatments have transformed HIV/AIDS from an inevitably fatal disease to one commonly managed as a chronic illness. Many children born with HIV infection, who previously suffered brief life spans, are now surviving into adulthood. This creates the need to understand more fully the obstacles these youth encounter in becoming independent, productive adults. In adults, HIV commonly is associated with impairments in memory and executive functions (such as inhibition, cognitive flexibility, and problem solving), which increase the risk of problems in day-to-day functioning, including medication nonadherence. Studies of memory and executive functions in children and youth with HIV infection are extremely limited, however, and none have included measures of prospective memory (that is, the ability to execute a future intention), which is a particularly robust predictor of daily functioning in adults with HIV. Furthermore, our current understanding of the functional impact of HIV on brain development is limited. The study proposed here would be the first to evaluate the complex interplay between development and HIV infection on memory and executive functions in the context of important functional outcomes in an effort to advance the clinical science of pediatric neuroAIDS. The study will test the hypotheses that: 1) perinatally acquired HIV is associated with deficits in memory and executive functioning; 2) HIV severity and history, including age at greatest disease severity, will be associated with degree of impairment in memory and executive functioning ; 3) developmental change and changes in HIV severity will interact to influence these functions over time; and 4) impairments in memory and executive function contribute to problems in daily functioning (including medication adherence, academic achievement, and adaptive behavior). Using a longitudinal design to examine and control for developmental changes in these functions during adolescence, we will administer measures of verbal and nonverbal retrospective memory, prospective memory, executive functions, and medication adherence to 200 HIV-infected and 75 uninfected youth age 9-18 at two time points, two years apart. Data will be collected at eight sites participating in a large national, longitudinal study of outcomes of perinatal HIV infection, the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol, thus allowing us to examine memory and executive functioning in an efficient and cost-effective manner in the larger context of demographic, health-related, cognitive, and behavioral aspects of perinatal HIV infection. This is an important area for investigation because deficits in memory and executive function in youth with HIV could have wide-ranging effects on their acquisition of health and medication management skills, adaptive and academic functioning, behavior, and, ultimately, social and occupational outcome in adulthood. We anticipate this study will not only elucidate developmental neurocognitive aspects of perinatally acquired HIV but will also provide important information and additional tools to target areas of intervention for perinatally HIV-infected youth at risk for poor functional outcomes.

描述（由申请人提供）：当前的治疗已将艾滋病毒/艾滋病从不可避免的致命疾病转变为通常被视为慢性病的疾病。许多以前遭受短暂寿命的艾滋病毒感染的儿童现在已经成年了。这创造了需要更充分地了解这些青年在成为独立，生产力的成年人方面遇到的障碍。在成年人中，艾滋病毒通常与记忆和执行功能的损害有关（例如抑制，认知灵活性和解决问题），这增加了日常功能中问题的风险，包括药物不遵守。然而，对艾滋病毒感染儿童和青少年的记忆和执行功能的研究极为有限，但没有一个包括预期记忆的度量（即执行未来意图的能力），这是艾滋病毒成年人日常功能的特别强大的预测指标。此外，我们目前对HIV对脑发育的功能影响的理解是有限的。在这里提出的研究将是第一个在重要功能结果的背景下评估记忆和执行功能之间发育和HIV感染之间的复杂相互作用的研究，以促进儿科神经辅助的临床科学。该研究将检验以下假设：1）围产期获得的艾滋病毒与记忆和执行功能的缺陷有关； 2）艾滋病毒的严重性和历史，包括最大的疾病严重程度的年龄，将与记忆和执行功能的损害程度有关； 3）发育变化和HIV严重程度的变化将相互作用，以影响这些功能随着时间的推移； 4）记忆和执行功能的障碍会导致日常功能的问题（包括药物依从性，学术成就和适应性行为）。使用纵向设计来检查和控制青春期这些功能的发展变化，我们将管理口头和非语言回顾性记忆，前瞻性记忆，执行功能以及对200 HIV感染的HIV感染和75名未感染的9-18岁的未感染的年龄在两年的时间点，两年，两年。数据将在参加大型国家围产期HIV感染预后的八个站点，小儿HIV/AIDS同伴研究青春期的主要协议，从而使我们能够以更大的人性化，健康，认知，认知，认知和行为的影响，以有效和成本效益的方式检查记忆和执行功能。这是调查的重要领域，因为艾滋病毒年轻人的记忆和执行功能的缺陷可能会对他们对健康和药物管理技能的获取，适应性和学术功能，行为，最终在成年后的社会和职业结果产生广泛的影响。我们预计，这项研究不仅将阐明围产期获得的艾滋病毒的发育神经认知方面，而且还将提供重要的信息和其他工具，以针对干预领域的围产期艾滋病毒感染的年轻人有差有功能不良的结果。