Imaging of Brain Structural and Functional Effects in People With Human Immunodeficiency Virus

Area of Science:

• Neuroscience
• Medical Imaging
• Infectious Diseases

Background:

• Antiretroviral therapy has reduced opportunistic CNS infections in people with HIV (PWH).
• Despite viral suppression, PWH experience persistent neuropsychiatric impairment and organ damage, indicating ongoing brain injury.
• Subtle structural and functional brain alterations in PWH require sensitive neuroimaging detection methods.

Approach:

• Review of existing and emerging neuroimaging tools for detecting HIV-associated brain pathology.
• Strategies for adjusting neuroimaging findings for confounders like age, sex, substance use, and comorbidities.
• Emphasis on parallel neuroimaging approaches for complementary data acquisition.

Key Points:

• Neuroimaging methods must be sensitive to subtle HIV-associated brain abnormalities.
• Confounding factors require careful consideration in neuroimaging studies of PWH.
• Combining experimental and statistical controls enhances biotype identification.
• Data aggregation from multiple studies can increase sample size for advanced analyses.

Conclusions:

• Sensitive neuroimaging is crucial for understanding persistent brain injury in virally suppressed PWH.
• Standardized neuroimaging protocols could facilitate future research on CNS complications in PWH.
• Identifying distinct patient biotypes is key to developing targeted interventions for neurological changes in PWH.