Psychomotor functioning of HIV positive adolescents on antiretroviral treatment in Johannesburg, South Africa.

[摘要] In 2009 an estimated 33 million people were living with the Human Immunodeficiency Virus(HIV). Of this global population, 35% live in South Africa. Furthermore, sub-Saharan Africais home to 80% of the world’s population of HIV-1 positive children and adolescents. Themost prominent form of transmission of HIV in children in South Africa is from mother tochild. Until 2004, South Africans had limited access to ARV treatment at and after birth dueto the government legislation. As a consequence, treatment of HIV in children may only havebeen initiated after clinical presentation of immune deficiency. Therefore, currently, HIV-1positive adolescents born during the period of restricted ARV-access may have experiencedphysical and developmental symptoms associated with the virus including neurologicaldeficits, prior to initiating treatment. This study investigated the current psychomotorfunctioning, such as psychomotor speed, manual dexterity, graphomotor and visual-motorcoordination of a group of low socio-economic HIV-1 positive adolescents in Johannesburg,South Africa, who are now on a managed antiretroviral programme and how this compared toa HIV negative contrast group. A Mann-Whitney U Test indicated a significant difference inmean non-dominant hand performance in the Grooved Pegboard Test between the two groups(U = 738, p < .05), with the HIV positive group performing slower than the HIV negativegroup. An independent samples t-test indicated a significant difference between groups in theBlock Design subtest of the WISC-R [t(88) = -2.93, p < .01] where the HIV positive groupperformed significantly worse than the HIV negative group. Additionally, a Mann-Whitney UTest revealed a significant difference in number of errors made in the WISC-R Mazes subtestbetween groups (U = 736.50, p < .05), where the HIV negative group made more errors.Another Mann-Whitney U Test revealed a significant difference between groups in theROCFT Copy score (U = 534.50, p < .01) where the HIV positive group achieved asignificantly lower score than the HIV negative group. Lastly, a Mann-Whitney U Testdemonstrated significant differences between the groups in the Trail Making Test A time (U= 445.00, p < .01), Trail Making Test B time (U = 509.00, p < .01), the number of errorsmade on the Trail Making Test B (U = 729.00, p < .05) and the difference between TrailMaking Test B – A time (U = 769.50, p < .05) with the HIV positive group performingslower and making more errors in Part B than the contrast group. The findings of the currentstudy imply that HIV-1 vertically-infected adolescents in Johannesburg, South Africa, on adelayed HAART programme appear to have persisting difficulties in complex psychomotorskills where an integration of functions is required. Furthermore, these results indicate anoverall poor psychomotor performance in comparison to international normative data,supporting previous findings. Developmental, remedial and therapeutic recommendationswere made.

[发布机构] University of the Witwatersrand