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Structural Brain Abnormalities in Successfully Treated HIV Infection: Associations With Disease and Cerebrospinal
Rosan A van Zoest1, Jonathan Underwood2, Davide De Francesco3
1Department of Global Health, Academic Medical Center, and Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.
The Journal of Infectious Diseases
|October 26, 2017
Summary
People with HIV on treatment show reduced brain gray matter and white matter integrity, linked to past AIDS and systemic issues like hypertension and inflammation.
Area of Science:
- Neuroimaging
- HIV/AIDS Research
- Biomarkers
Background:
- Brain structural abnormalities are noted in people living with HIV (PLWH) on combination antiretroviral therapy (cART).
- The underlying causes of these brain changes in PLWH remain unclear.
Purpose of the Study:
- To investigate factors associated with brain tissue volumes and white matter microstructure in PLWH on suppressive cART.
- To compare these factors with HIV-negative controls.
Main Methods:
- Neuroimaging and cerebrospinal fluid biomarkers were used in 134 PLWH and 79 HIV-negative controls (age ≥45).
- Assessed gray matter volumes and white matter fractional anisotropy.
- Analyzed associations with hypertension and soluble CD14 levels.
Main Results:
- PLWH had significantly lower gray matter volumes and fractional anisotropy compared to controls.
- Individuals with prior clinical AIDS showed the most pronounced differences.
- Hypertension and cerebrospinal fluid soluble CD14 were linked to reduced white matter integrity, independent of HIV status.
Conclusions:
- Reduced brain volumes and white matter abnormalities in treated PLWH are partly due to historical AIDS effects and systemic factors like hypertension and neuroinflammation.
- Further research is needed to identify all mechanisms contributing to brain structure abnormalities in treated HIV infection.
