White matter measures are near normal in controlled HIV infection except in those with cognitive impairment and longer HIV duration.
The objective of the current study was to quantify the degree of white matter (WM) abnormalities in chronic and virally suppressed HIV-infected (HIV+) persons while carefully taking into account demographic and disease factors. Diffusion tensor imaging (DTI) was conducted in 40 HIV- and 82 HIV+ men with comparable demographics and life style factors. The HIV+ sample was clinically stable with successful viral control. Diffusion was measured across 32 non-colinear directions with a b-value of 1000 s/mm2; fractional anisotropy (FA) and mean diffusivity (MD) maps were quantified with Itrack IDL. Using the ENIGMA DTI protocol, FA and MD values were extracted for each participant and in 11 skeleton regions of interest (SROI) from standard labels in the JHU ICBM-81 atlas covering major striato-frontal and parietal tracks. We found no major differences in FA and MD values across the 11 SROI between study groups. Within the HIV+ sample, we found that a higher CNS penetrating antiretroviral treatment, higher current CD4+ T cell count, and immune recovery from the nadir CD4+ T cell count were associated with increased FA and decreased MD (p < 0.05-0.006), while HIV duration, symptomatic, and asymptomatic cognitive impairment were associated with decreased FA and increased MD (p < 0.01-0.004). Stability of HIV treatment and antiretroviral CNS penetration efficiency in addition to current and historical immune recovery were related to higher FA and lower MD (p = 0.04-p < 0.01). In conclusion, WM DTI measures are near normal except for patients with neurocognitive impairment and longer HIV disease duration.
Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia. lcysique@unsw.edu.au.|Faculty of Medicine, UNSW Australia, Sydney, 2052, NSW, Australia. lcysique@unsw.edu.au.|Peter Duncan Neuroscience Research Unit at the St. Vincent's Applied Medical Research Centre, Darlinghurst, 2010, NSW, Australia. lcysique@unsw.edu.au.
Lucette A
LA
Cysique
Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.
James R
JR
Soares
Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.
Guangqiang
G
Geng
Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.
Maia
M
Scarpetta
Department of Imaging, St. Vincent's Hospital, Darlinghurst, 2010, NSW, Australia.
Kirsten
K
Moffat
Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.
Michael
M
Green
Faculty of Medicine, UNSW Australia, Sydney, 2052, NSW, Australia.|Peter Duncan Neuroscience Research Unit at the St. Vincent's Applied Medical Research Centre, Darlinghurst, 2010, NSW, Australia.|Department of Neurology, Sydney St. Vincent's Hospital, Darlinghurst, 2010, NSW, Australia.|Department of Immunology, Sydney St. Vincent's Hospital, Darlinghurst, 2010, NSW, Australia.
Bruce J
BJ
Brew
School of Medicine, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
Roland G
RG
Henry
Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.|Faculty of Medicine, UNSW Australia, Sydney, 2052, NSW, Australia.
Caroline
C
Rae
D000368:Aged; D016880:Anisotropy; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D001921:Brain / Q000000981:diagnostic imaging* / Q000276:immunology / Q000821:virology; D001931:Brain Mapping; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D056324:Diffusion Tensor Imaging; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D019562:Viral Load / Q000187:drug effects; D066127:White Matter / Q000000981:diagnostic imaging* / Q000276:immunology / Q000821:virology
D019380:Anti-HIV Agents
Antiretroviral treatment; Diffusion tensor imaging; HIV-associated neurocognitive disorder; HIV/AIDS; Immune functions