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  • 1From the Computational, Cognitive & Clinical Neuroimaging Laboratory, Division of Brain Sciences, Department of Medicine (J.H.C., R.L., D.J.S.), and Division of Infectious Diseases (J.U., A.W.), Imperial College London, UK; Departments of Radiology (M.W.A.C., C.B.L.M.M.), Global Health, Amsterdam Institute for Global Health and Development (AIGHD) (R.A.v.Z., F.W.N.M.W., P.R.), Neurology (P.P., B.A.S.), and Medical Psychology (G.J.G., B.A.S.), Academic Medical Center, Amsterdam, the Netherlands; Department of Infection & Population Health (D.D.F., C.A.S.), University College London, UK; Dutch HIV Monitoring Foundation (F.W.N.M.W., P.R.); Department of Neurology (P.P.), OLVG Hospital; Public Health Service of Amsterdam (M.F.S.v.d.L.), the Netherlands; and Alma Mater Studiorum (C.F.), University of Bologna, Italy. james.cole@imperial.ac.uk.

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HIV disease is linked to apparent brain aging, even with viral suppression. This increased brain aging correlates with cognitive decline but not infection duration, suggesting HIV accentuates brain aging.

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Area of Science:

  • Neuroimaging and Neuroscience
  • Infectious Diseases and Virology
  • Gerontology and Aging Research

Background:

  • Human Immunodeficiency Virus (HIV) infection can impact brain health.
  • Understanding age-related brain changes in people with HIV is crucial for long-term care.
  • Neuroimaging offers potential biomarkers for brain aging.

Purpose of the Study:

  • To determine if HIV is associated with accelerated brain aging using neuroimaging.
  • To investigate the relationship between apparent brain age and cognitive performance in HIV.
  • To explore correlations between brain aging estimates and HIV-specific clinical factors.

Main Methods:

  • Utilized T1-weighted MRI scans from a large cohort of virologically suppressed HIV-positive adults and HIV-negative controls.
  • Employed a machine-learning model trained on a healthy aging cohort to estimate brain-predicted age.
  • Calculated brain-predicted age difference (brain-PAD) and assessed cognitive function and clinical parameters.

Main Results:

  • HIV-positive individuals exhibited a significantly greater brain-PAD score compared to HIV-negative controls.
  • Higher brain-PAD scores correlated with poorer performance in cognitive domains, including processing speed, executive function, and memory.
  • Brain-PAD was not associated with chronological age, duration of HIV, or other HIV-related clinical measures.

Conclusions:

  • Apparent brain aging is increased in adults with HIV, irrespective of viral suppression.
  • The degree of apparent brain aging is linked to cognitive deficits in the HIV-positive population.
  • HIV may accentuate brain aging processes rather than accelerate them, independent of infection duration.