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

Content Provider	Springer Nature Link
Author	Gongvatana, Assawin Cohen, Ronald A. Correia, Stephen Devlin, Kathryn N. Miles, Jadrian Kang, Hakmook Ombao, Hernando Navia, Bradford Laidlaw, David H. Tashima, Karen T.
Copyright Year	2011
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.
Starting Page	477
Ending Page	486
Page Count	10
File Format	PDF
ISSN	13550284
Journal	Journal of NeuroVirology
Volume Number	17
Issue Number	5
e-ISSN	15382443
Language	English
Publisher	Springer US
Publisher Date	2011-10-01
Publisher Place	Boston
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	HIV infection Hepatitis C infection Antiretroviral treatment Cerebral white matter Neuroimaging Diffusion tensor imaging Immunology Infectious Diseases Virology Neurosciences Neurology
Content Type	Text
Resource Type	Article
Subject	Neurology Virology Neurology (clinical) Cellular and Molecular Neuroscience

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