Normal structural brain development in adolescents treated for perinatally acquired HIV: a longitudinal imaging study

Area of Science:

• Neuroscience
• Pediatrics
• Infectious Diseases

Background:

• Cross-sectional studies indicate lower brain volumes and white matter integrity in children with perinatally acquired HIV (PHIV).
• Previous research on the NOVICE cohort highlighted these structural differences in PHIV-positive children compared to controls.

Purpose of the Study:

• To longitudinally investigate changes in brain structure over time in adolescents with PHIV.
• To determine if initial differences in white matter and grey matter volumes persist or change during adolescence.

Main Methods:

• Follow-up MRI scans were conducted on participants from the NOVICE cohort after approximately 4.6 years.
• Measurements included total white matter and grey matter volume, white matter hyperintensities (WMH) volume, and white matter integrity using T1-weighted, FLAIR, and DTI sequences.
• Multivariable linear mixed effects models were used to compare rates of change between PHIV-positive and HIV-negative groups, adjusting for sex and age.

Main Results:

• No statistically significant differences in the rate of change were observed between groups for white matter volume, WMH volume, or white matter integrity.
• A trend suggested that total grey matter volume decreased significantly less in the PHIV group, but this finding lost statistical significance after adjusting for height.
• No HIV-associated determinants for reduced grey matter pruning or associations with cognitive development were identified.

Conclusions:

• Adolescents with PHIV receiving long-term antiretroviral therapy exhibit largely normal structural brain development.
• The study suggests that current treatment strategies may mitigate long-term structural brain abnormalities in this population.