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J Acquir Immune Defic Syndr. 2016 Dec 1;73(4):374-383.

Topographies of Cortical and Subcortical Volume Loss in HIV and Aging in the cART Era.

Author information

1
Departments of *Neurology; †Bioengineering; ‡Radiology, Washington University in Saint Louis, St. Louis, MO; and §Hope Center for Neurological Disorders, Washington University in Saint Louis, St. Louis, MO.

Abstract

OBJECTIVES:

Studies of HIV-associated brain atrophy often focus on a priori brain regions of interest, which can introduce bias. A data-driven, minimally biased approach was used to analyze changes in brain volumetrics associated with HIV and their relationship to aging, viral factors, combination antiretroviral therapy (cART), and gender, and smoking.

DESIGN:

A cross-sectional study of 51 HIV-uninfected (HIV-) and 146 HIV-infected (HIV+) participants.

METHODS:

Structural MRI of participants was analyzed using principal component analysis (PCA) to reduce dimensionality and determine topographies of volumetric changes. Neuropsychological (NP) assessment was examined using global and domain-specific scores. The effects of HIV disease factors (eg, viral load, CD4, etc.) on brain volumes and neuropsychological were investigated using penalized regression (LASSO).

RESULTS:

Two components of interest were visualized using principal component analysis. An aging effect predominated for both components. The first component, a cortically weighted topography, accounted for a majority of variance across participants (43.5% of variance) and showed independent effects of HIV and smoking. A secondary, subcortically weighted topography (4.6%) showed HIV-status accentuated age-related volume loss. In HIV+ patients, the cortical topography correlated with global neuropsychological scores and nadir CD4, whereas subcortical volume loss was associated with recent viral load.

CONCLUSIONS:

Cortical regions showed the most prominent volumetric changes because of aging and HIV. Within HIV+ participants, cortical volumes were associated with immune history, whereas subcortical changes correlated with current immune function. Cognitive function was primarily associated with cortical volume changes. Observed volumetric changes in chronic HIV+ patients may reflect both past infection history and current viral status.

PMID:
27454251
PMCID:
PMC5085858
DOI:
10.1097/QAI.0000000000001111
[Indexed for MEDLINE]
Free PMC Article

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