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Structural and functional brain imaging in acute HIV.

Vishal Samboju1, Carissa L Philippi2, Phillip Chan3

  • 1Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA.

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This summary is machine-generated.

This study found minimal brain structural and functional changes in acute HIV infection (AHI). Early combination antiretroviral treatment (ART) may preserve brain integrity, but longitudinal studies are needed to confirm long-term effects.

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Area of Science:

  • Neuroimaging
  • Infectious Diseases
  • Neurology

Background:

  • Acute HIV infection (AHI) can present with neurological symptoms and cognitive impairment.
  • HIV RNA is detectable in cerebrospinal fluid (CSF) early after exposure.
  • Brain microstructural integrity and functional connectivity may be affected in AHI.

Purpose of the Study:

  • To investigate white matter microstructure and resting-state functional connectivity (rsFC) in individuals with AHI.
  • To assess potential disruptions in brain integrity during the early stages of HIV infection.

Main Methods:

  • Diffusion tensor imaging (DTI) and rsFC were used to examine 49 individuals with AHI and 23 HIV-uninfected controls.
  • MRI scans were performed before or shortly after initiation of combination antiretroviral treatment (ART).
  • Analyses included fractional anisotropy (FA), diffusivity metrics, and seed-based rsFC of multiple brain networks.

Main Results:

  • No significant differences in DTI metrics between AHI and control groups.
  • Within the AHI group, early ART exposure correlated with improved white matter integrity (higher FA, lower RD/MD) in specific tracts.
  • Reduced rsFC was observed in the AHI group between the default mode network (DMN) and frontal regions; higher CD4 count and better neuropsychological scores (NPZ-4) correlated with increased rsFC in certain DMN regions.

Conclusions:

  • Early-stage HIV infection shows minimal disruption to structural and functional brain integrity.
  • Brief ART exposure in AHI may be associated with preserved white matter integrity.
  • Longitudinal studies are essential to determine if early ART initiation prevents long-term brain dysfunction in HIV.