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Brain Structural Changes following HIV Infection: Meta-Analysis.

E E O'Connor1, Timothy A Zeffiro2, Thomas A Zeffiro2

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Summary

Structural neuroimaging studies show HIV infection impacts brain volume, but results vary. Quantitative measures reliably detect these HIV effects, serving as biomarkers despite treatment changes over time.

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Area of Science:

  • Neuroimaging
  • HIV/AIDS Research
  • Brain Structure

Background:

  • Numerous studies have investigated HIV's effects on brain macroarchitecture using structural neuroimaging.
  • Inconsistencies in reported changes in brain volumes (total, gray matter, white matter, CSF, basal ganglia) exist across studies.

Purpose of the Study:

  • To evaluate the consistency and temporal stability of HIV serostatus effects on structural neuroimaging measures.
  • To synthesize existing research on HIV's impact on brain structure.

Main Methods:

  • A meta-analysis of 19 cross-sectional studies (1993-2016) reporting HIV effects on cortical and subcortical volumes.
  • Random-effects meta-analysis and meta-regression were used to assess standardized mean differences, heterogeneity, and the influence of publication year.

Main Results:

  • Significant reductions in total brain volume (SMD=-0.65, P=.002) and gray matter volume (SMD=-0.28, P=.008) were associated with HIV serostatus.
  • Cerebrospinal fluid (CSF) volume was significantly increased (SMD=0.56, P=.001) in individuals with HIV.
  • High between-study heterogeneity was observed, with publication year influencing neurostructural effects.

Conclusions:

  • Substantial variations in published findings are likely due to evolving HIV treatment practices and imaging methods over time.
  • Despite variations, quantitative neuroimaging measures are reliable biomarkers for detecting HIV's effects on brain structure during treatment.