title: Regional brain structural dysmorphology in human immunodeficiency virus infection: effects of acquired immune deficiency syndrome, alcoholism, and age.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection and alcoholism each carries liability for disruption of brain structure and function integrity. Despite considerable prevalence of HIV-alcoholism comorbidity, few studies examined the potentially heightened burden of disease comorbidity.
  
  
  METHODS
  Participants were 342 men and women: 110 alcoholics, 59 with HIV infection, 65 with HIV infection and alcoholism, and 108 healthy control subjects. This design enabled examination of independent and combined effects of HIV infection and alcoholism along with other factors (acquired immune deficiency syndrome [AIDS]-defining events, hepatitis C infection, age) on regional brain volumes derived from T1-weighted magnetic resonance images.
  
  
  RESULTS
  Brain volumes, expressed as Z scores corrected for intracranial volume and age, were measured in 20 tissue and 5 ventricular and sulcal regions. The most profound and consistent volume deficits occurred with alcohol use disorders, notable in the cortical mantle, insular and anterior cingulate cortices, thalamus, corpus callosum, and frontal sulci. The HIV-only group had smaller thalamic and larger frontal sulcal volumes than control subjects. HIV disease-related factors associated with greater volume abnormalities included CD4 cell count nadir, clinical staging, history of AIDS-defining events, infection age, and current age. Longer sobriety and less lifetime alcohol consumption were predictive of attenuated brain volume abnormalities in both alcohol groups.
  
  
  CONCLUSIONS
  Having HIV infection with alcoholism and AIDS had an especially poor outcome on brain structures. That longer periods of sobriety and less lifetime alcohol consumption were predictive of attenuated brain volume abnormalities encourages the inclusion of alcohol recovery efforts in HIV/AIDS therapeutic settings.
authors.affiliation: Neuroscience Program, SRI International, Menlo Park, California, USA.
authors.forename: Adolf
authors.initials: A
authors.lastname: Pfefferbaum
authors.forename: Margaret J
authors.initials: MJ
authors.lastname: Rosenbloom
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Sassoon
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kemper
authors.forename: Stanley
authors.initials: S
authors.lastname: Deresinski
authors.forename: Torsten
authors.initials: T
authors.lastname: Rohlfing
authors.forename: Edith V
authors.initials: EV
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000473:pathology* / Q000503:physiopathology; D000437:Alcoholism / Q000150:complications / Q000473:pathology*; D000704:Analysis of Variance; D018791:CD4 Lymphocyte Count; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000473:pathology*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009929:Organ Size; D012044:Regression Analysis