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Age exacerbates HIV-associated white matter abnormalities

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Abstract

Both HIV disease and advanced age have been associated with alterations to cerebral white matter, as measured with white matter hyperintensities (WMH) on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI), and more recently with diffusion tensor imaging (DTI). This study investigates the combined effects of age and HIV serostatus on WMH and DTI measures, as well as the relationships between these white matter measures, in 88 HIV seropositive (HIV+) and 49 seronegative (HIV−) individuals aged 23–79 years. A whole-brain volumetric measure of WMH was quantified from FLAIR images using a semi-automated process, while fractional anisotropy (FA) was calculated for 15 regions of a whole-brain white matter skeleton generated using tract-based spatial statistics (TBSS). An age by HIV interaction was found indicating a significant association between WMH and older age in HIV+ participants only. Similarly, significant age by HIV interactions were found indicating stronger associations between older age and decreased FA in the posterior limbs of the internal capsules, cerebral peduncles, and anterior corona radiata in HIV+ vs. HIV− participants. The interactive effects of HIV and age were stronger with respect to whole-brain WMH than for any of the FA measures. Among HIV+ participants, greater WMH and lower anterior corona radiata FA were associated with active hepatitis C virus infection, a history of AIDS, and higher current CD4 cell count. Results indicate that age exacerbates HIV-associated abnormalities of whole-brain WMH and fronto-subcortical white matter integrity.

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Abbreviations

BBB:

Blood brain barrier

cART:

Combination antiretroviral therapy

DTI:

Diffusion tensor imaging

FA:

Fractional anisotropy

FLAIR:

Fluid-attenuated inversion recovery

HCV:

Hepatitis C virus

HIV:

Human immunodeficiency virus-1

HIV+:

HIV positive

HIV−:

HIV negative

ICV:

Intracranial volume

MRI:

Magnetic resonance imaging

ROI:

Region of interest

TBSS:

Tract-based spatial statistics

WMH:

White matter hyperintensities

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Acknowledgments

This work was supported by grants from the National Institute of Mental Health (R01 MH074368), the Lifespan/Tufts/Brown Center for AIDS Research (P30 AI042853), the National Institute of Alcohol Abuse and Alcoholism (P01 AA019072), the National Institute of Neurological Disorders and Stroke (R01 NS080655), the Enigma Center for Worldwide Medicine (U54 EB020403), and the Southern HIV Alcohol Research Consortium (U24 AA022002). Support was also provided by the McKnight Brain Research Foundation and the University of Florida Center for Cognitive Aging and Memory.

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The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Center for Cognitive Aging and Memory (CAM), Institute on Aging, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA

    Talia R. Seider, Adam J. Woods, Eric C. Porges, Tiffany Cummings & Ronald A. Cohen

  2. Department of Clinical and Healthy Psychology, University of Florida, Gainesville, FL, 32611, USA

    Talia R. Seider, Tiffany Cummings & Ronald A. Cohen

  3. Department of Psychiatry, University of California San Diego, La Jolla, CA, 92093, USA

    Assawin Gongvatana

  4. Department of Psychiatry and Human Behavior, Brown University, Providence, RI, 02912, USA

    Assawin Gongvatana & Stephen Correia

  5. Department of Biostatistics, University of Florida, Gainesville, FL, 32610, USA

    Huaihou Chen

  6. Department of Medicine, Brown University, Providence, RI, 02903, USA

    Karen Tashima

  7. AIDS Clinical Trial Unit, The Miriam Hospital, Providence, RI, 02903, USA

    Karen Tashima

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  1. Talia R. Seider
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  2. Assawin Gongvatana
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  3. Adam J. Woods
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  4. Huaihou Chen
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  5. Eric C. Porges
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  7. Stephen Correia
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  8. Karen Tashima
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  9. Ronald A. Cohen
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Correspondence to Ronald A. Cohen.

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Seider, T.R., Gongvatana, A., Woods, A.J. et al. Age exacerbates HIV-associated white matter abnormalities. J. Neurovirol. 22, 201–212 (2016). https://doi.org/10.1007/s13365-015-0386-3

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