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01.10.2011

Clinical contributors to cerebral white matter integrity in HIV-infected individuals

verfasst von: Assawin Gongvatana, Ronald A. Cohen, Stephen Correia, Kathryn N. Devlin, Jadrian Miles, Hakmook Kang, Hernando Ombao, Bradford Navia, David H. Laidlaw, Karen T. Tashima

Erschienen in: Journal of NeuroVirology | Ausgabe 5/2011

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Abstract

HIV-infected people frequently exhibit brain dysfunction characterized by preferential damage to the cerebral white matter. Despite suppressed viral load and reconstituted immune function afforded by combination antiretroviral therapy (CART), brain dysfunction continues to be observed even in medically stable individuals. To provide insight into the etiology of HIV-associated brain dysfunction in the CART era, we examined the effects of HIV disease markers, antiretroviral treatment, hepatitis C (HCV) coinfection, and age on DTI measures of white matter integrity in a cohort of 85 individuals aged 23 to 65 years with chronic HIV infection. Fractional anisotropy and mean diffusivity were derived from 29 cerebral white matter regions, which were segmented on each individual brain using a high-resolution T1-weighted image and registered to diffusion images. Significant effects of clinical variables were found on white matter abnormalities in nearly all brain regions examined. Most notably, HCV coinfection and older age were associated with decreased anisotropy or increased diffusivity in the majority of brain regions. Individuals with higher current CD4 levels exhibited higher anisotropy in parietal lobe regions, while those undergoing antiretroviral treatment exhibited higher anisotropy in temporal lobe regions. The observed diffuse pattern of white matter injury suggests that future neuroimaging studies should employ methodologies that are not limited to circumscribed regions of interest. The current findings underline the multifactorial nature of HIV-associated brain dysfunction in the CART era, and the importance of examining the effects of HIV disease in the context of other comorbidities, in particular HCV coinfection and aging.

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Titel: Clinical contributors to cerebral white matter integrity in HIV-infected individuals
verfasst von: Assawin Gongvatana
Ronald A. Cohen
Stephen Correia
Kathryn N. Devlin
Jadrian Miles
Hakmook Kang
Hernando Ombao
Bradford Navia
David H. Laidlaw
Karen T. Tashima
Publikationsdatum: 01.10.2011
Verlag: Springer US
Erschienen in: Journal of NeuroVirology / Ausgabe 5/2011
Print ISSN: 1355-0284
Elektronische ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-011-0055-0

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