艾滋病儿童的社会经济地位和认知功能:来自赞比亚艾滋病相关神经认知障碍(HANDZ)研究的证据(p1 -1.虚拟)

摘要目的:建立赞比亚艾滋病毒感染儿童和青少年的社会经济地位和认知功能之间的关系模型

背景:多项先前的研究已经确定了儿童艾滋病毒对认知功能的有害影响。社会经济地位(SES)是认知表现的最强预测因子之一，并可能影响艾滋病毒与认知之间的关系。

设计/方法:作为正在进行的赞比亚艾滋病毒相关神经认知障碍(HANDZ)研究的一部分，这是一项前瞻性队列研究，我们招募了208名艾滋病毒感染者和208名未感染艾滋病毒的对照组，年龄均为8-17岁。研究人员使用标准化问卷来评估SES，所有参与者都进行了全面的神经心理测试。得出了NPZ8评分作为认知功能的总结测量。采用Logistic和线性回归方法建立SES与认知功能的关系模型，并通过中介分析确定SES影响认知的具体途径。

结果:艾滋病毒感染儿童在认知功能的综合测量中表现明显较差(NPZ8评分- 0.19 vs. 0.22, p <0.001)，并且更有可能出现认知障碍(33% vs. 19%， p=0.001)。在两组中，较高的SES与认知障碍风险降低相关(OR 0.8, 95% CI 0.75-0.92, p<0.001)，在HIV和HEU组的儿童中效果相似。与未感染对照组相比，SES与HIV感染儿童NPZ8评分的相关性更强(Pearson的R为0.39 vs 0.28)，但在两组中均可预测NPZ8。中介分析显示，营养不良对SES的认知功能影响的中介作用最强。

结论:认知功能与艾滋病毒感染儿童的SES密切相关，这表明艾滋病毒和贫困对认知功能有协同作用。

披露:Esau G. Mbewe获得了美国国立卫生研究院国家神经疾病和中风研究所的研究支持，资助号为K23NS117310。Pelekelo kula没有什么可透露的。Sylvia Mwanza-Kabaghe没有什么可透露的。Milimo Mweemba没有什么可透露的。布达没有什么可透露的。希瑟·亚当斯研究所获得了来自美国国立卫生研究院的研究支持;过去:Abeona;巴顿研究联盟;美国大学残疾研究中心。希瑟·亚当斯(Heather Adams)的直系亲属获得了一份与医疗保健有关的出版物的版税。 Heather Adams has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Critical Path Institute. Dr. Birbeck has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for American Neurological Association. An immediate family member of Dr. Birbeck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. The institution of Dr. Birbeck has received research support from NIH. Dr. Birbeck has received personal compensation in the range of $500-$4,999 for serving as a Advisory Board with NIH FIC. Dr. Birbeck has a non-compensated relationship as a Ambassador for Zambia with RSTMH that is relevant to AAN interests or activities. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Bearden has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for law firms.