Implications of Combined Exposure to Household Air Pollution and HIV on Neurocognition in Children

Megan K. Suter, Catherine J. Karr, Grace C. John-Stewart, Laurén A. Gómez, Hellen Moraa, Duke Nyatika, Dalton Wamalwa, Michael Paulsen, Christopher D. Simpson, Niloufar Ghodsian, Michael J. Boivin, Paul Bangirana and Sarah Benki-Nugent
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Megan K. Suter: Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA
Catherine J. Karr: Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA
Grace C. John-Stewart: Department of Epidemiology, University of Washington School of Public Health, Seattle, WA 98195, USA
Laurén A. Gómez: Department of Global Health, University of Washington School of Public Health, Seattle, WA 98104, USA
Hellen Moraa: Department of Paediatrics and Child Health, University of Nairobi, Nairobi 30197, Kenya
Duke Nyatika: Department of Paediatrics and Child Health, University of Nairobi, Nairobi 30197, Kenya
Dalton Wamalwa: Department of Paediatrics and Child Health, University of Nairobi, Nairobi 30197, Kenya
Michael Paulsen: Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98195, USA
Christopher D. Simpson: Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98195, USA
Niloufar Ghodsian: Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA 98195, USA
Michael J. Boivin: Department of Psychiatry, Michigan State University, East Lansing, MI 48824, USA
Paul Bangirana: Department of Psychiatry, Makerere University College of Health Sciences, Kampala 7062, Uganda
Sarah Benki-Nugent: Department of Global Health, University of Washington School of Public Health, Seattle, WA 98104, USA

IJERPH, 2018, vol. 15, issue 1, 1-13

Abstract: Air pollution exposure and HIV infection can each cause neurocognitive insult in children. The purpose of this study was to test whether children with combined high air pollution exposure and perinatal HIV infection have even greater risk of neurocognitive impairment. This was a cross-sectional study of HIV-uninfected unexposed (HUU) and HIV-infected children and their caregivers in Nairobi, Kenya. We used a detailed neuropsychological battery to evaluate neurocognitive functioning in several domains. We measured caregiver 24-h personal CO exposure as a proxy for child CO exposure and child urinary 1-hydroxypyrene (1-OHP), a biomarker for exposure to polycyclic aromatic hydrocarbons (PAHs). Median 24-h caregiver CO exposure was 6.1 and 3.7 ppm for 45 HIV-infected (mean age 6.6 years) and 49 HUU (mean age 6.7 years), respectively; 48.5% of HIV-infected and 38.6% of HUU had caregiver 24-h CO levels exceeding the WHO recommended level. Median 1-OHP exposure was 0.6 and 0.7 µmol/mol creatinine among HIV-infected and HUU children, respectively. HIV-infected children with high urinary 1-OHP (exceeding 0.68 µmol/mol creatinine) had significantly lower global cognition ( p = 0.04), delayed memory ( p = 0.01), and attention scores ( p = 0.003). Among HUU children, urinary 1-OHP and caregiver 24-h caregiver CO were not significantly associated with neurocognitive function. Our findings suggest that combined chronic exposure to air pollutants and perinatal HIV infection may be associated with poorer neurocognitive outcomes. High prevalence of air pollution exposure highlights the need to reduce these exposures.

Keywords: 1-hydroxypyrene; carbon monoxide; neurocognition; polycyclic aromatic hydrocarbon; HIV; Sub-Saharan Africa; household air pollution; pediatric (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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