title: The impact of human immune deficiency virus and hepatitis C coinfection on white matter microstructural integrity.
abstract: The purpose of the present study is to examine the integrity of white matter microstructure among individuals coinfected with HIV and HCV using diffusion tensor imaging (DTI). Twenty-five HIV+ patients, 21 HIV+/HCV+ patients, and 25 HIV- controls were included in this study. All HIV+ individuals were stable on combination antiretroviral therapy (cART; ≥3 months). All participants completed MRI and neuropsychological measures. Clinical variables including liver function, HIV-viral load, and CD4 count were collected from the patient groups. DTI metrics including mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and fractional anisotropy (FA) from five subregions of the corpus callosum were compared across groups. The HIV+/HCV+ group and HIV+ group were similar in terms of HIV clinical variables. None of the participants met criteria for cirrhosis or fibrosis. Within the anterior corpus callosum, significant differences were observed between both HIV+ groups compared to HIV- controls on DTI measures. HIV+ and HIV+/HCV+ groups had significantly lower FA values and higher MD and RD values compared to HIV- controls; however, no differences were present between the HIV+ and HIV+/HCV+ groups. Duration of HIV infection was significantly related to DTI metrics in total corpus callosum FA only, but not other markers of HIV disease burden or neurocognitive function. Both HIV+ and HIV+/HCV+ individuals had significant alterations in white matter integrity within the corpus callosum; however, there was no evidence for an additive effect of HCV coinfection. The association between DTI metrics and duration of HIV infection suggests that HIV may continue to negatively impact white matter integrity even in well-controlled disease.
authors.affiliation: Missouri Institute of Mental Health, University of Missouri-St. Louis, 4633 World Parkway St. Louis, St. Louis, MO, 63134, USA. jodi.heaps@mimh.edu.
authors.forename: J M
authors.initials: JM
authors.lastname: Heaps-Woodruff
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, USA.
authors.forename: P W
authors.initials: PW
authors.lastname: Wright
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, USA.|Department of Radiology, Washington University School of Medicine, St. Louis, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Ances
authors.affiliation: Department of Neurology, Washington University School of Medicine, St. Louis, USA.
authors.forename: D
authors.initials: D
authors.lastname: Clifford
authors.affiliation: Missouri Institute of Mental Health, University of Missouri-St. Louis, 4633 World Parkway St. Louis, St. Louis, MO, 63134, USA.
authors.forename: R H
authors.initials: RH
authors.lastname: Paul
mesh_terms: D000328:Adult; D016880:Anisotropy; D000998:Antiviral Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D060085:Coinfection; D003337:Corpus Callosum / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology / Q000821:virology; D056324:Diffusion Tensor Imaging; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity / Q000502:physiology; D016174:Hepacivirus / Q000472:pathogenicity / Q000502:physiology; D006526:Hepatitis C / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D066127:White Matter / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology / Q000821:virology
chemical_list: D000998:Antiviral Agents
keywords: DTI; HCV; HIV; White matter