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14.02.2019

Progressive brain atrophy in chronically infected and treated HIV+ individuals

verfasst von: Talia M. Nir, Neda Jahanshad, Christopher R. K. Ching, Ronald A. Cohen, Jaroslaw Harezlak, Giovanni Schifitto, Hei Y. Lam, Xue Hua, Jianhui Zhong, Tong Zhu, Michael J. Taylor, Thomas B. Campbell, Eric S. Daar, Elyse J. Singer, Jeffry R. Alger, Paul M. Thompson, Bradford A. Navia, On behalf of the HIV Neuroimaging Consortium

Erschienen in: Journal of NeuroVirology | Ausgabe 3/2019

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Abstract

Growing evidence points to persistent neurological injury in chronic HIV infection. It remains unclear whether chronically HIV-infected individuals on combined antiretroviral therapy (cART) develop progressive brain injury and impaired neurocognitive function despite successful viral suppression and immunological restoration. In a longitudinal neuroimaging study for the HIV Neuroimaging Consortium (HIVNC), we used tensor-based morphometry to map the annual rate of change of regional brain volumes (mean time interval 1.0 ± 0.5 yrs), in 155 chronically infected and treated HIV+ participants (mean age 48.0 ± 8.9 years; 83.9% male) . We tested for associations between rates of brain tissue loss and clinical measures of infection severity (nadir or baseline CD4+ cell count and baseline HIV plasma RNA concentration), HIV duration, cART CNS penetration-effectiveness scores, age, as well as change in AIDS Dementia Complex stage. We found significant brain tissue loss across HIV+ participants, including those neuro-asymptomatic with undetectable viral loads, largely localized to subcortical regions. Measures of disease severity, age, and neurocognitive decline were associated with greater atrophy. Chronically HIV-infected and treated individuals may undergo progressive brain tissue loss despite stable and effective cART, which may contribute to neurocognitive decline. Understanding neurological complications of chronic infection and identifying factors associated with atrophy may help inform strategies to maintain brain health in people living with HIV.

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Titel: Progressive brain atrophy in chronically infected and treated HIV+ individuals
verfasst von: Talia M. Nir
Neda Jahanshad
Christopher R. K. Ching
Ronald A. Cohen
Jaroslaw Harezlak
Giovanni Schifitto
Hei Y. Lam
Xue Hua
Jianhui Zhong
Tong Zhu
Michael J. Taylor
Thomas B. Campbell
Eric S. Daar
Elyse J. Singer
Jeffry R. Alger
Paul M. Thompson
Bradford A. Navia
On behalf of the HIV Neuroimaging Consortium
Publikationsdatum: 14.02.2019
Verlag: Springer International Publishing
Erschienen in: Journal of NeuroVirology / Ausgabe 3/2019
Print ISSN: 1355-0284
Elektronische ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-019-00723-4

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Progressive brain atrophy in chronically infected and treated HIV+ individuals

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