Changes in neurodevelopmental outcomes from 24 to 36 months among children HIV-exposed uninfected (CHEU) and HIV-unexposed (CHU).

Authors

Ruchi Tiwari, Brent R Collett, Irene Oucho, Collins Otieno, Priscah Lihanda, Ariana Magedson, Mareme Diakhate, Grace C John-Stewart, Grace M Aldrovandi, Dalton Wamalwa, Benson O Singa, Sarah Benki-Nugent, Christine J McGrath

Published in

AIDS (London, England). Aug 13, 2026. Epub Aug 13, 2026.

Abstract

To compare neurodevelopment through 36 months between breastfed children who are HIV-exposed and uninfected (CHEU) exposed to maternal dolutegravir (DTG)-based antiretroviral therapy (ART) and children born to mothers without HIV (CHU).
We enrolled a prospective cohort of pregnant women with and without HIV in Migori, Kenya, and followed infants to 36 months. Neurodevelopment was assessed at 24 and 36 months using the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4). Outcomes included cognitive, language, and motor z-scores, domain-specific delay (z-score<-1SD), and any delay. Multivariable linear and Poisson regression compared CHEU and CHU, and mixed-effects models evaluated developmental trajectories.
Among 293 children (CHEU = 149; CHU = 144), 49% were female and 9% were preterm. Breastfeeding at 12 months was similar between groups. Most CHEU (89%) were DTG-exposed in-utero. At 24 months, 43% had any delay (42% CHEU; 44% CHU), with similar prevalence at 36 months (37% CHEU; 35% CHU). Risk of fine motor delay was significantly higher among CHEU in unadjusted analyses but not after adjustment. Bayley-4 scores and trajectories did not differ between groups.
Fine motor delay was more common among CHEU, but lack of difference in adjusted analyses suggests these delays were likely attributable to socio-demographic rather than biologic factors. The high prevalence of delays in both groups underscores the strong influence of environmental and nutritional factors on early child development.

PMID:
42592846
Bibliographic data and abstract were imported from PubMed on 13 Aug 2026.

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