Progressive brain atrophy in chronically infected and treated HIV+ individuals

On behalf of the HIV Neuroimaging Consortium

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Growing evidence points to persistent neurological injury in chronic HIV infection. It remains unclear whether chronically HIV-infected individuals on combined antiretroviral therapy (cART) develop progressive brain injury and impaired neurocognitive function despite successful viral suppression and immunological restoration. In a longitudinal neuroimaging study for the HIV Neuroimaging Consortium (HIVNC), we used tensor-based morphometry to map the annual rate of change of regional brain volumes (mean time interval 1.0 ± 0.5 yrs), in 155 chronically infected and treated HIV+ participants (mean age 48.0 ± 8.9 years; 83.9% male). We tested for associations between rates of brain tissue loss and clinical measures of infection severity (nadir or baseline CD4+ cell count and baseline HIV plasma RNA concentration), HIV duration, cART CNS penetration-effectiveness scores, age, as well as change in AIDS Dementia Complex stage. We found significant brain tissue loss across HIV+ participants, including those neuro-asymptomatic with undetectable viral loads, largely localized to subcortical regions. Measures of disease severity, age, and neurocognitive decline were associated with greater atrophy. Chronically HIV-infected and treated individuals may undergo progressive brain tissue loss despite stable and effective cART, which may contribute to neurocognitive decline. Understanding neurological complications of chronic infection and identifying factors associated with atrophy may help inform strategies to maintain brain health in people living with HIV.

Original languageEnglish (US)
JournalJournal of NeuroVirology
DOIs
StatePublished - Jan 1 2019

Fingerprint

Atrophy
HIV
Brain
Neuroimaging
AIDS Dementia Complex
CD4 Lymphocyte Count
Infection
Viral Load
Brain Injuries
HIV Infections
Longitudinal Studies
Therapeutics
RNA
Health
Wounds and Injuries

Keywords

  • ADC
  • Brain volume
  • cART
  • HIV
  • MRI
  • TBM

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Virology

Cite this

Progressive brain atrophy in chronically infected and treated HIV+ individuals. / On behalf of the HIV Neuroimaging Consortium.

In: Journal of NeuroVirology, 01.01.2019.

Research output: Contribution to journalArticle

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