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Pediatr Infect Dis J. 2018 Jul;37(7):662-668. doi: 10.1097/INF.0000000000001852.

Structural Neuroimaging and Neuropsychologic Signatures in Children With Vertically Acquired HIV.

Author information

1
From the Missouri Institute of Mental Health, University of Missouri, St. Louis, Missouri.
2
HIV Netherlands Australia Thailand (HIV-NAT) Research Collaboration, Thai Red Cross AIDS Research Center, Bangkok, Thailand.
3
Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of the University of Southern California, Marina del Rey, California.
4
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
5
Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
6
Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
7
Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
8
Nakornping Hospital, Chiang Mai, Thailand.
9
Prapokklao Hospital, Chantaburi, Thailand.
10
Queen Savang Vadhana Memorial Hospital, Chongburi, Thailand.
11
Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
12
Department of Radiology, Chiang Mai University, Chiang Mai, Thailand.
13
Memory and Aging Center, Department of Neurology, University of California, San Francisco, California.
14
The University of Amsterdam, Amsterdam, the Netherlands.
15
The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
16
Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, Maryland.

Abstract

BACKGROUND:

Children with vertically acquired HIV exhibit persistent cognitive impairments, yet the corresponding neuroimaging signature of vertical infection remains unclear.

METHODS:

Fifty healthy control children and 51 vertically infected children were included in the study. The HIV-infected group consisted of survivors who had not received antiretroviral therapy at birth. The HIV-infected group averaged 11.4 (2.5) years of age, with a median CD4 count of 683 cells/mm. Most (71%) of the HIV-infected children were on antiretroviral therapy for a median of 34 months (range: 33-42) with HIV RNA <40 copies/mL in 89% of the sample. The HIV-uninfected group averaged 10.6 (2.6) years of age. Magnetic resonance imaging was acquired to determine volumes of the caudate, putamen, thalamus, pallidum, hippocampus, nucleus accumbens, total white matter, total gray matter and cortical gray matter. Correlational analyses examined the degree of shared variance between brain volumes and both cognitive performances and laboratory markers of disease activity (T cells and plasma viral load).

RESULTS:

HIV-infected children exhibited larger volumes of the caudate, nucleus accumbens, total gray matter and cortical gray matter when compared with the controls. Volumetric differences were predominately evident in children under 12 years of age. HIV-infected children performed worse than controls on most neuropsychologic tests, though neither cognitive performances nor laboratory markers corresponded to brain volumes in the HIV-infected children.

CONCLUSIONS:

Outcomes of the present study suggest abnormal brain maturation among HIV-infected pediatric survivors. Longitudinal studies of brain integrity and related resilience factors are needed to determine the impact of neuroimaging abnormalities on psychosocial function in pediatric HIV.

PMID:
29200184
PMCID:
PMC5984109
[Available on 2019-07-01]
DOI:
10.1097/INF.0000000000001852

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