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Basal ganglia shrinkage without remarkable hippocampal atrophy in chronic aviremic HIV-positive patients

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Abstract

Conventional magnetic-resonance (MR) imaging is not sensitive enough in depicting subtle neurodegenerative changes that occur during chronic HIV infection with good peripheral viral suppression. The aim of this study was to compare brain volumes in HIV-positive subjects with age- and education-matched healthy controls with regard to influence of aging and immunologic parameters. An overall of 65 subjects (40 HIV-positive and 25 age-, gender-, and education-matched healthy subjects) underwent conventional MR imaging with three-dimensional sequence adequate for volumetric measurements. Volumes of specific brain regions were measured and compared between HIV-positive and healthy subjects using Student t test. Correlations between obtained brain volumes and immunologic parameters were determined using Pearson’s correlation test. Influence of age as a covariate was determined using ANCOVA test. Statistical value was set at p < 0.05. Volumes of nucleus accumbens (p = 0.003), putamen (p = 0.003), and thalamus (p = 0.046) were significantly decreased in HIV-positive subjects compared with healthy, while volumes of lateral ventricles were significantly increased (p = 0.043). However, influence of age on atrophy was greater than presence of HIV infection in all observed volumes. Positive correlation of nadir CD4+ count and nucleus accumbens volume was obtained, as well as of therapy with lateral ventricle volumes. Volumes of putamen correlated negatively with duration of therapy. HIV-associated atrophic changes are visible in nucleus accumbens, putamen, and thalamus in neurocognitively asymptomatic stage, while no changes can be observed in the hippocampus, affected by other types of dementias. Under therapy, the influence of physiological aging on HIV-associated atrophy is greater than the presence of HIV infection per se.

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Funding

This research was conducted with the grants of Provincial Secretariat for Science and Technological Development of Vojvodina, grants No. 142-451-2486/2016-01 and 114.451-2514/2015-02.

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Authors and Affiliations

  1. Clinical Center of Vojvodina, Clinic for Ear, Nose and Throat, Hajduk Veljkova 1, Novi Sad, 21000, Serbia

    Tamara Tesic

  2. Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia

    Jasmina Boban, Mladen Bjelan, Aleksandar Todorovic, Dusko Kozic & Snezana Brkic

  3. Oncology Institute of Vojvodina, Center for Diagnostic Imaging, Put dr Goldmana 4, Sremska Kamenica, 21204, Serbia

    Jasmina Boban, Mladen Bjelan, Aleksandar Todorovic & Dusko Kozic

  4. Clinical Center of Vojvodina, Clinic for Infectious Diseases, Hajduk Veljkova 1, Novi Sad, 21000, Serbia

    Snezana Brkic

Authors
  1. Tamara Tesic
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  2. Jasmina Boban
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  3. Mladen Bjelan
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  4. Aleksandar Todorovic
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  5. Dusko Kozic
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  6. Snezana Brkic
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Correspondence to Jasmina Boban.

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Tesic, T., Boban, J., Bjelan, M. et al. Basal ganglia shrinkage without remarkable hippocampal atrophy in chronic aviremic HIV-positive patients. J. Neurovirol. 24, 478–487 (2018). https://doi.org/10.1007/s13365-018-0635-3

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  • DOI: https://doi.org/10.1007/s13365-018-0635-3

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