Regional areas and widths of the midsagittal corpus callosum among HIV-infected patients on stable antiretroviral therapies

David F. Tate, Mehul Sampat, Jaroslaw Harezlak, Mark Fiecas, Joseph Hogan, Jeffrey Dewey, Daniel McCaffrey, Daniel Branson, Troy Russell, Jared Conley, Michael Taylor, Giavoni Schifitto, J. Zhong, Eric S. Daar, Jeffrey Alger, Mark Brown, Elyse Singer, T. Campbell, D. McMahon, Y. TsoJanetta Matesan, Scott Letendre, S. Paulose, Michelle Gaugh, C. Tripoli, Constantine Yiannoutsos, Erin D. Bigler, Ronald A. Cohen, Charles R.G. Guttmann, Bradford Navia

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Recent reports suggest that a growing number of human immunodeficiency virus (HIV)-infected persons show signs of persistent cognitive impairment even in the context of combination antiretroviral therapies (cART). The basis for this finding remains poorly understood as there are only a limited number of studies examining the relationship between CNS injury, measures of disease severity, and cognitive function in the setting of stable disease. This study examined the effects of HIV infection on cerebral white matter using quantitative morphometry of the midsagittal corpus callosum (CC) in 216 chronically infected participants from the multisite HIV Neuroimaging Consortium study currently receiving cART and 139 controls. All participants underwent MRI assessment, and HIV-infected subjects also underwent measures of cognitive function and disease severity. The midsagittal slice of the CC was quantified using two semi-automated procedures. Group comparisons were accomplished using ANOVA, and the relationship between CC morphometry and clinical covariates (current CD4, nadir CD4, plasma and CSF HIV RNA, duration of HIV infection, age, and ADC stage) was assessed using linear regression models. HIV-infected patients showed significant reductions in both the area and linear widths for several regions of the CC. Significant relationships were found with ADC stage and nadir CD4 cell count, but no other clinical variables. Despite effective treatment, significant and possibly irreversible structural loss of the white matter persists in the setting of chronic HIV disease. A history of advanced immune suppression is a strong predictor of this complication and suggests that antiretroviral intervention at earlier stages of infection may be warranted.

Original languageEnglish (US)
Pages (from-to)368-379
Number of pages12
JournalJournal of NeuroVirology
Volume17
Issue number4
DOIs
StatePublished - Aug 1 2011

Keywords

  • CART
  • Corpus callosum
  • HIV
  • Nadir CD4
  • White matter

ASJC Scopus subject areas

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

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    Tate, D. F., Sampat, M., Harezlak, J., Fiecas, M., Hogan, J., Dewey, J., McCaffrey, D., Branson, D., Russell, T., Conley, J., Taylor, M., Schifitto, G., Zhong, J., Daar, E. S., Alger, J., Brown, M., Singer, E., Campbell, T., McMahon, D., ... Navia, B. (2011). Regional areas and widths of the midsagittal corpus callosum among HIV-infected patients on stable antiretroviral therapies. Journal of NeuroVirology, 17(4), 368-379. https://doi.org/10.1007/s13365-011-0033-6