Serum Vitamin D is Di erentially Associated with Socioemotional Adjustment in Early School-Aged Ugandan Children According to Perinatal HIV Status and In Utero/Peripartum Antiretroviral Exposure History

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dc.contributor.authorYakah, William
dc.contributor.authorFenton, Jenifer I.
dc.contributor.authorSikorskii, Alla
dc.contributor.authorZalwango, Sarah K.
dc.contributor.authorTuke, Robert
dc.contributor.authorMusoke, Philippa
dc.contributor.authorBoivin, Michael J.
dc.contributor.authorGiordani, Bruno
dc.contributor.authorEzeamama, Amara E.
dc.date.accessioned2022-01-31T19:13:31Z
dc.date.available2022-01-31T19:13:31Z
dc.date.issued2019
dc.description.abstractAn impact of vitamin D in neurocognitive function has been theorized but it remains unknown whether vitamin-D insufficiency (VDI) is associated with worse socio-emotional adjustment (SEA) in vulnerable early school-aged children. This study examines the thesis that deficits in SEA are related to VDI using longitudinal data from 254 children that are perinatally HIV-infected (PHIV), exposed-uninfected (HEU), or unexposed-uninfected (HUU). In utero/peripartum antiretroviral (IPA) exposure was established per medical record documentation of biological mother’s ART regimen in pregnancy. Four caregiver-reported age- and sex-standardized measures of SEA were obtained at months 0, 6, and 12 for dependent children aged 6–10 years: externalizing problems (EPC), internalizing problems (IPC), behavioral symptoms index (BSI), and adaptive skills index (ASI). VDI was highly prevalent (74%, n = 188), and its association with change in SEA measures over 12 months varied by HIV-status (VDI*HIV, all p-values < 0.03). There was further variation in relationship of vitamin-D to SEA by IPA among PHIV (for ASI, BSI, and EPC, vitamin-D*IPA, p-value ≤ 0.01) and HEU (for BSI and EPC, vitamin-D*IPA, p-value ≤ 0.04). Among HUU, BSI (β = −0.32, 95% CI: −0.50, −0.13), IPC (β = −0.28, 95% CI: −0.47, −0.09), and EPC (β = −0.20, 95% CI: −0.37, −0.02) all declined moderately per quartile increment in VD. Among PHIV, on the one hand higher vitamin D predicted ASI gains (moderate vs. low VD, β = 0.52, p = 0.002), but this protective association was absent for BSI, EPC, and IPC (β = 0.36–0.77, p < 0.05). In absence of IPA-exposure, increasing vitamin-D predicted declines in BSI and EPC (moderate vs. low Vitamin D, β = −0.56 to −0.71, p ≤ 0.02) among HEU. However, given IPA exposure among HEU, higher VDI predicted moderate elevation in BSI (β = 0.39, 95% CI: 0.00, 0.78) and IPC (β = 0.48, 95% CI: 0.05, 0.92). Interaction between VD and IPA exposure for SEA outcomes among HEU and PHIV children warrants further investigation. The vitamin-D associated SEA improvement among HUU and HEU without IPA exposure suggests vitamin-D supplementation may remediate behavioral and adaptive deficits in this groups. View Full-Texten_US
dc.identifier.citationYakah, W., Fenton, J. I., Sikorskii, A., Zalwango, S. K., Tuke, R., Musoke, P., ... & Ezeamama, A. E. (2019). Serum Vitamin D is differentially associated with socioemotional adjustment in early school-aged Ugandan children according to perinatal HIV status and In utero/peripartum antiretroviral exposure history. Nutrients, 11(7), 1570.https://doi.org/10.3390/nu11071570en_US
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/1693
dc.language.isoenen_US
dc.publisherNutrientsen_US
dc.subjectvitamin D; antiretroviral therapy; perinatal HIV infection; Uganda; cognition; socioemotional adjustmenten_US
dc.titleSerum Vitamin D is Di erentially Associated with Socioemotional Adjustment in Early School-Aged Ugandan Children According to Perinatal HIV Status and In Utero/Peripartum Antiretroviral Exposure Historyen_US
dc.typeArticleen_US
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Serum Vitamin D is Differentially Associated with Socioemotional Adjustment in Early School-Aged Ugandan Children According to Perinatal HIV Status and In Utero/Peripartum Antiretroviral Exposure History
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