- Author
-
M. Van den Hof
- Title
- Growing up with HIV
- Subtitle
- Research into brain development and long-term health
- Supervisors
-
P. Reiss
- Co-supervisors
-
D. Pajkrt
F.W.N.M. Wit - Award date
- 19 November 2020
- Number of pages
- 215
- ISBN
- 9789463614764
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
With this thesis, we aimed to investigate whether current HIV care, including the use of contemporary suppressive antiretroviral treatment, results in normal brain development in PHIV-positive children growing into adulthood. Our research shows that, indeed, when adolescents receive suppressive treatment, long-term brain development is for the most part similar to HIV-negative peers. This thesis identified one exception, delayed development in cognitive executive functioning, which we explain as the possible outcome of cerebral damage acquired in early life when HIV replication was not yet controlled by the use of cART. While our overall results look promising, this thesis also shows that adolescents living with PHIV continue to show poorer cognitive performance and more extensive brain abnormalities compared to their peers. I believe that, to further improve the long-term health of children at risk or living with PHIV globally, and to spend available money most wisely, we should prioritize three specific areas: (1) the prevention of HIV transmission and in particular mother-to-child HIV transmission, (2) early HIV diagnosis and immediate effective, well-tolerated, and least toxic treatment when HIV is diagnosed, and finally, (3) tertiary prevention to reduce complications.
- Note
- Please note that the acknowledgements section is not included in the thesis downloads.
- Persistent Identifier
- https://hdl.handle.net/11245.1/9aabdc81-ed65-4618-9d48-9d610b38c077
- Downloads
-
Thesis
Front matter
Chapter 1: General introduction
Chapter 2: Brain structure of perinatally HIV-infected patients on long-term treatment: A systematic review
Chapter 3: Normal structural brain development in adolescents treated for perinatally acquired HIV: A longitudinal study
Chapter 4: Neurocognitive development in perinatally human immunodeficiency virus-infected adolescents on long-term treatment, compared to healthy matched controls: A longitudinal study
Chapter 5: Adoption status is not associated with long-term immunological and virological outcomes among perinatally HIV-infected children in the Netherlands
Chapter 6: Lower IQ and poorer cognitive profiles in perinatally HIV-infected children is not associated with having a background of international adoption
Chapter 7: Central nervous system penetration of antiretroviral therapy in HIV-infected children
Chapter 8: Elevated lipoprotein(a) in perinatally HIV-infected children compared with healthy ethnicity-matched controls
Chapter 9: General discussion
Chapter 10: Summary & Nederlandse samenvatting
Abbreviations; Contributing authors and affiliations; NOVICE and ATHENA cohort study group; PhD portfolio; List of publications; About the author
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