title: Regional areas and widths of the midsagittal corpus callosum among HIV-infected patients on stable antiretroviral therapies.
abstract: Recent reports suggest that a growing number of human immunodeficiency virus (HIV)-infected persons show signs of persistent cognitive impairment even in the context of combination antiretroviral therapies (cART). The basis for this finding remains poorly understood as there are only a limited number of studies examining the relationship between CNS injury, measures of disease severity, and cognitive function in the setting of stable disease. This study examined the effects of HIV infection on cerebral white matter using quantitative morphometry of the midsagittal corpus callosum (CC) in 216 chronically infected participants from the multisite HIV Neuroimaging Consortium study currently receiving cART and 139 controls. All participants underwent MRI assessment, and HIV-infected subjects also underwent measures of cognitive function and disease severity. The midsagittal slice of the CC was quantified using two semi-automated procedures. Group comparisons were accomplished using ANOVA, and the relationship between CC morphometry and clinical covariates (current CD4, nadir CD4, plasma and CSF HIV RNA, duration of HIV infection, age, and ADC stage) was assessed using linear regression models. HIV-infected patients showed significant reductions in both the area and linear widths for several regions of the CC. Significant relationships were found with ADC stage and nadir CD4 cell count, but no other clinical variables. Despite effective treatment, significant and possibly irreversible structural loss of the white matter persists in the setting of chronic HIV disease. A history of advanced immune suppression is a strong predictor of this complication and suggests that antiretroviral intervention at earlier stages of infection may be warranted.
authors.affiliation: Departments of Radiology and Psychiatry, Center for Neurological Imaging, The Brigham and Women's Hospital, Harvard Medical School, Boston, MA USA. dftatephd@mac.com
authors.forename: David F
authors.initials: DF
authors.lastname: Tate
authors.forename: Mehul
authors.initials: M
authors.lastname: Sampat
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Harezlak
authors.forename: Mark
authors.initials: M
authors.lastname: Fiecas
authors.forename: Joseph
authors.initials: J
authors.lastname: Hogan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Dewey
authors.forename: Daniel
authors.initials: D
authors.lastname: McCaffrey
authors.forename: Daniel
authors.initials: D
authors.lastname: Branson
authors.forename: Troy
authors.initials: T
authors.lastname: Russell
authors.forename: Jared
authors.initials: J
authors.lastname: Conley
authors.forename: Michael
authors.initials: M
authors.lastname: Taylor
authors.forename: Giovanni
authors.initials: G
authors.lastname: Schifitto
authors.forename: Giavoni
authors.initials: G
authors.lastname: Schifitto
authors.forename: J
authors.initials: J
authors.lastname: Zhong
authors.forename: Eric S
authors.initials: ES
authors.lastname: Daar
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Alger
authors.forename: Mark
authors.initials: M
authors.lastname: Brown
authors.forename: Elyse
authors.initials: E
authors.lastname: Singer
authors.forename: T
authors.initials: T
authors.lastname: Campbell
authors.forename: D
authors.initials: D
authors.lastname: McMahon
authors.forename: Y
authors.initials: Y
authors.lastname: Tso
authors.forename: Janetta
authors.initials: J
authors.lastname: Matesan
authors.forename: Scott
authors.initials: S
authors.lastname: Letendre
authors.forename: S
authors.initials: S
authors.lastname: Paulose
authors.forename: Michelle
authors.initials: M
authors.lastname: Gaugh
authors.forename: C
authors.initials: C
authors.lastname: Tripoli
authors.forename: Constantine
authors.initials: C
authors.lastname: Yiannoutsos
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
authors.forename: Charles R G
authors.initials: CR
authors.lastname: Guttmann
authors.forename: Bradford
authors.initials: B
authors.lastname: Navia
mesh_terms: D015526:AIDS Dementia Complex / Q000097:blood / Q000209:etiology / Q000276:immunology / Q000473:pathology* / Q000821:virology; D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D016022:Case-Control Studies; D003071:Cognition; D003337:Corpus Callosum / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D005260:Female; D006678:HIV / Q000502:physiology*; D015658:HIV Infections / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000276:immunology / Q000473:pathology* / Q000821:virology; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D016014:Linear Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods*; D012367:RNA, Viral / Q000097:blood; D012720:Severity of Illness Index; D019562:Viral Load / Q000502:physiology
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral