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Pediatr Infect Dis J. 2015 Sep;34(9):e211-6. doi: 10.1097/INF.0000000000000774.

Brain Imaging and Neurodevelopment in HIV-uninfected Thai Children Born to HIV-infected Mothers.

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From the *Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine of USC, University of Southern California, Marina del Rey, California; †Faculty of Nursing and Health Professions, Department of Public Health, University of San Francisco, California; ‡HIV-NAT, The Thai Red Cross AIDS Research Center, Bangkok, Thailand; §Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand; ¶Department of Neurology, Pediatrics, Engineering, Psychiatry, Radiology, & Ophthalmology, University of Southern California, Los Angeles, California; ‖Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand; **Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; ††Memory and Aging Center, Department of Neurology, University of California, San Francisco, California; ‡‡Department of Psychology, University of Missouri, St. Louis, Missouri; §§Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, Maryland; ¶¶Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland; ‖‖SEARCH-Thailand, Bangkok, Thailand; and ***Department of Geriatric Medicine, University of California, San Francisco, California.



Perinatal use of combination antiretroviral therapy dramatically reduces vertical (mother-to-child) transmission of HIV but has led to a growing population of children with perinatal HIV-exposure but uninfected (HEU). HIV can cause neurological injury among children born with infection, but the neuroanatomical and developmental effects in HEU children are poorly understood.


We used structural magnetic resonance imaging with diffusion tensor imaging to compare brain anatomy between 30 HEU and 33 age-matched HIV-unexposed and uninfected (HUU) children from Thailand. Maps of brain volume and microstructural anatomy were compared across groups; associations were tested between neuroimaging measures and concurrent neuropsychological test performance.


Mean (standard deviation) age of children was 10.3 (2.8) years, and 58% were male. All were enrolled in school and lived with family members. Intelligence quotient (IQ) did not differ between groups. Caretaker education levels did not differ, but income was higher for HUU (P < 0.001). We did not detect group differences in brain volume or diffusion tensor imaging metrics, after controlling for sociodemographic factors. The mean (95% confidence interval) fractional anisotropy in the corpus callosum was 0.375 (0.368-0.381) in HEU compared with 0.370 (0.364-0.375) in HUU. Higher fractional anisotropy and lower mean diffusivity were each associated with higher IQ scores in analyses with both groups combined.


No differences in neuroanatomical or brain integrity measures were detectable in HEU children compared with age-matched and sex-matched controls (HUU children). Expected associations between brain integrity measures and IQ scores were identified suggesting sufficient power to detect subtle associations that were present.

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