This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.HIV (human immunodeficiency virus) is a neurotropic virus which, in perinatally-infected individuals, is present at the time of birth and is able to cross the blood brain barrier, suggesting that its effects may present differently at different developmental stages. Central Nervous System (CNS) effects of the virus may not just be due to direct cellular damage, but may also be related to treatment neurotoxicities and length of exposure to antiretroviral therapies. As an example of these more diffuse CNS effects, recent data suggest that perinatally HIV-infected children and adolescents have significantly higher rates of psychiatric hospitalizations when compared to both HIV-exposed but uninfected children and adolescents, as well as the general pediatric population, underscoring the ongoing cumulative toxicity of the virus, and perhaps its treatments. P1055 is a multicenter, non-treatment, observational study of the effect of HIV on the prevalence and severity of psychiatric symptoms in 400 perinatally HIV-infected children and adolescents ages 6 to <18 as compared to a demographically matched control group of 400 children and adolescents who are uninfected but HIV-exposed, or are living with a household member who is HIV infected. Enrollment of HIV-infected subjects will be stratified by gender and age group (6 to < 12 or > 12 to < 18), and then control subjects will be selected to be frequency matched within the four strata created by gender and age group. All 800 subjects will be assessed for the prevalence and severity of psychiatric symptoms at entry and at approximately 1 year (48 weeks) and 2 years (96 weeks) after entry. In addition, a subset of 200-240 HIV-infected subjects and control subjects (100 - 120 in each group) and their parents/primary caregivers will participate in semi-structured psychiatric interviews to clinically evaluate tentative psychiatric diagnoses based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition) defined disorders. This subset will be limited to certain pre-selected sites, and may be limited to English-speaking subjects. Understanding the means by which co-occurring symptoms develop in the HIV-infected population, as compared to the control population, could inform prevention and early intervention efforts to decrease the likelihood that these children and adolescents would have to deal with additional psychosocial stressors.
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