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Published on: January 12, 2016
Cerebral function in perinatally HIV-infected young adults and their HIV-uninfected sibling controls
Insights
Young adults with perinatally acquired HIV (PaHIV) show memory deficits and increased inflammatory markers in the brain compared to HIV-negative controls. These findings highlight cognitive differences in PaHIV individuals, distinct from those seen in adult HIV infection.
Area of Science:
- Neuroscience
- Infectious Diseases
- Pediatrics
Background:
- Perinatally acquired HIV (PaHIV) infection impacts neurodevelopment, with potential neurocognitive (NC) impairment due to HIV and antiretroviral therapy.
- Limited data exists on NC function in PaHIV young adults, necessitating comparison with HIV-negative controls.
Purpose of the Study:
- To compare cerebral function in young adults with PaHIV infection against age-matched HIV-negative family controls.
- To investigate neurocognitive performance and cerebral metabolites in PaHIV individuals.
Main Methods:
- Recruited 33 PaHIV young adults (Group 1) and 14 HIV-uninfected controls (Group 2).
- Assessed cerebral function using CogState(TM) NC battery, IHDS, and PRMQ.
- Utilized (1)H-MRS to measure basal ganglia metabolites in a subset of participants.
Main Results:
- No significant differences in overall NC function or IHDS scores between groups.
- PaHIV young adults reported significantly higher memory difficulties (PRMQ scores).
- Elevated inflammatory markers (choline and myo-inositol to creatine ratios) in basal ganglia observed in PaHIV group via (1)H-MRS.
Conclusions:
- PaHIV young adults exhibit distinct cerebral function differences compared to controls, particularly in memory.
- The observed cognitive profile in PaHIV differs from typical neurocognitive impairments seen in adult HIV infection.
Background:
Perinatally acquired HIV-infected (PaHIV) young adults undergo neurodevelopment in the presence of HIV infection and antiretroviral therapy, which may lead to neurocognitive (NC) impairment. Knowledge of NC function in this group is sparse and control data lacking. We compared cerebral function in young adults with PaHIV infection to aged matched HIV negative family controls.
Methods:
16-25-year-old PaHIV young adults (Group 1, n = 33) and HIV-uninfected family controls (Group 2, n = 14) were recruited. Cerebral function was evaluated by: a computerized battery assessing NC function (CogState(TM)), International HIV Dementia Scale (IHDS) and the prospective and retrospective memory questionnaire (PRMQ). Eight cases and four controls also underwent (1)H cerebral magnetic resonance spectroscopy ((1)H-MRS) scanning measuring basal ganglia (BG) metabolites. Cases and controls were compared.
Results:
Group 1 mean (SD) CD4 count; 444 (319) cells/μl, plasma HIV viral load < 50 in 55%. There were no statistically significant differences between study groups in NC function or IHDS results (P>0.27 all observations). PRMQ scores were significantly higher (42 versus 35, P = 0.02) and MRS BG inflammatory-metabolites (choline- and myo-inositol- to creatine ratios) were significantly greater in Group 1 versus Group 2 (0.83 versus 0.63, P = 0.02 and 3.43 versus 3.03.P = 0.09 respectively). No significant association between PRMQ score and MRS metabolites was observed (P = 0.89).
Conclusion:
Statistically significant differences in cerebral function parameters were observed in PaHIV young adults compared to a well-matched control population. The cognitive deficit observed, in memory, rather than fine motor function, differs from the cerebral impairment often reported in HIV-infected adults.
