AACAP: HIV-Infection in Children Leads to More Psychiatric Symptoms

October 31, 2006

SAN DIEGO -- For a variety of factors, HIV-infected children appear to have more psychiatric problems than uninfected children, researchers reported here.

SAN DIEGO, Oct. 31 -- For a variety of factors, HIV-infected children appear to have more psychiatric problems than uninfected children, researchers said here.

Caregivers reported significantly higher severity of generalized anxiety disorder and attention deficit hyperactivity disorder (ADHD), according to preliminary findings of an ongoing, multicenter, longitudinal study i study reported at the American Academy of Child and Adolescent Psychiatry meeting.

These findings show that perinatally infected children are at higher risk for developing psychopathology, likely due to effects of the virus on the central nervous system, neurotoxicity of antiretroviral medications, and psychosocial complications, said Jerry Heston, M.D., of St. Jude Children's Research Hospital in Memphis.

"As the domestic perinatally HIV-infected population ages, concern is mounting that long-term effects of HIV and its treatments may result in increased psychiatric disorders," he and colleagues said in a poster presentation.

Mean generalized anxiety severity scores were 3.29 for the 281 HIV-infected participants and 2.91 for the 244 uninfected children who were perinatally HIV-exposed or living in the same household of an HIV-infected person (P=0.032).

ADHD subcategory scores were also higher in HIV-infected children than uninfected controls, though only inattention severity was significantly different. The findings were:

  • ADHD inattention severity 8.23 versus 7.26 (P=0.041),
  • ADHD hyperactivity severity 5.13 versus 5.11 (P=0.485), and
  • ADHD combined severity 13.34 versus 12.35 (P=0141).

However, caregiver-reported Symptom Inventory-4 scores did not indicate significant differences for any of the measures except a lower incidence of conduct disorder in the control group than the infected group (10% versus 4%, P=0.0145).

"If you just look at diagnostic criteria reported by parents, you might not think they have more problems," Dr. Heston said, "but when you look at symptom severity you see they do."

The researchers reported these baseline findings of the ongoing study in these initially six- to 18-year-old children. The HIV-infected group was significantly older than the uninfected group (median 13.0 versus 11.2 years, P