Journal of NeuroVirology

, 17:477

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

Authors

  • Assawin Gongvatana
    • Warren Alpert Medical School of Brown University
    • Warren Alpert Medical School of Brown University
  • Stephen Correia
    • Warren Alpert Medical School of Brown University
  • Kathryn N. Devlin
    • Warren Alpert Medical School of Brown University
  • Jadrian Miles
    • Department of Computer ScienceBrown University
  • Hakmook Kang
    • Department of BiostatisticsVanderbilt University
  • Hernando Ombao
    • Department of BiostatisticsBrown University
  • Bradford Navia
    • Tufts University School of Medicine
  • David H. Laidlaw
    • Department of Computer ScienceBrown University
  • Karen T. Tashima
    • Warren Alpert Medical School of Brown University
Article

DOI: 10.1007/s13365-011-0055-0

Cite this article as:
Gongvatana, A., Cohen, R.A., Correia, S. et al. J. Neurovirol. (2011) 17: 477. doi:10.1007/s13365-011-0055-0

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.

Keywords

HIV infectionHepatitis C infectionAntiretroviral treatmentCerebral white matterNeuroimagingDiffusion tensor imaging

Copyright information

© Journal of NeuroVirology, Inc. 2011