TY - JOUR T1 - HUman immunodeficiency virus disease severity, psychiatric symptoms, and functional outcomes in perinatally infected youth AU - Nachman S, Chernoff M, Williams P, Hodge J, Heston J, Gadow KD Y1 - 2012/06/01 N1 - 10.1001/archpediatrics.2011.1785 JO - Archives of Pediatrics & Adolescent Medicine SP - 528 EP - 535 VL - 166 IS - 6 N2 - Objective  To evaluate associations between human immunodeficiency virus (HIV) disease severity and psychiatric and functional outcomes in youth with perinatal HIV infection.Design  Cross-sectional analysis of entry data from an observational, prospective 2-year study. Logistic and linear regression models adjusted for potential confounders were used.Setting  Twenty-nine sites of the International Maternal Pediatrics Adolescent AIDS Clinical Trials Group study in the United States and Puerto Rico.Participants  Youth aged 6 to 17 years who had HIV infection (N = 319).Main Exposures  Antiretroviral treatment and perinatal HIV infection.Main Outcome Measures  Youth and primary caregivers were administered an extensive battery of measures that assessed psychiatric symptoms; cognitive, social, and academic functioning; and quality of life.Results  Characteristics of HIV were a current CD4 percentage of 25% or greater (74% of participants), HIV RNA levels of less than 400 copies/mL (59%), and current highly active antiretroviral therapy (81%). Analyses indicated associations of past and current Centers for Disease Control and Prevention class C designation with less severe attention-deficit/hyperactivity disorder inattention symptoms, older age at nadir CD4 percentage and lower CD4 percentage at study entry with more severe conduct disorder symptoms, higher RNA viral load at study entry with more severe depression symptoms, and lower CD4 percentage at study entry with less severe symptoms of depression. There was little evidence of an association between specific antiretroviral therapy and severity of psychiatric symptoms. A lower nadir CD4 percentage was associated with lower quality of life, worse Wechsler Intelligence Scale for Children Coding Recall scores, and worse social functioning.Conclusion  Human immunodeficiency virus illness severity markers are associated with the severity of some psychiatric symptoms and, notably, with cognitive, academic, and social functioning, all of which warrant additional study.Trial Registration  clinicaltrials.gov Identifier: NCT00100542 SN - 1072-4710 M3 - doi: 10.1001/archpediatrics.2011.1785 UR - http://dx.doi.org/10.1001/archpediatrics.2011.1785 ER -