Journal of NeuroVirology

, 17:487

Platelet decline as a predictor of brain injury in HIV infection

  • Ann B. Ragin
  • Gypsyamber D’Souza
  • Sandra Reynolds
  • Eric Miller
  • Ned Sacktor
  • Ola A. Selnes
  • Eileen Martin
  • Barbara R. Visscher
  • James T. Becker
Article

Abstract

An association between platelet decline and increased risk of progression to dementia has been observed in an advanced HIV infection cohort study. This investigation evaluated the prognostic significance of platelet decline for dementia, for psychomotor slowing, and for brain injury, as quantified in vivo, in a much larger population of HIV+ men. Platelet counts and neurocognitive data were available from biannual visits of 2,125 HIV+ men participating in the prospective, Multicenter AIDS Cohort Study from 1984 to 2009. Brain volumetric data were also available from an imaging substudy of 83 seropositive participants aged 50 and older. The association of platelet counts with neurocognitive outcome was assessed using Cox proportional hazard models where change in platelet count from baseline was a time-updated variable. Marked platelet decline was associated with increased risk of dementia in univariate analysis (hazard ratio [HR] = 2.5, 95% confidence interval [CI] = 1.8–3.5), but not after adjustment for CD4 cell count, HIV viral load, age, study site, hemoglobin, race, education, smoking, and alcohol use (HR = 1.4, 95% CI = 0.78–2.5). Platelet decline did not predict psychomotor slowing in either univariate (HR = 0.79, 95% CI = 0.58–1.08) or multivariate (HR = 1.10, 95% CI = 0.73–1.67) analysis. Analysis of brain volumetric data, however, indicated a relationship between platelet decline and reduced gray matter volume fraction in univariate (p = 0.06) and multivariate (p < 0.05) analyses. Platelet decline was not an independent predictor of dementia or psychomotor slowing, after adjusting for stage of disease. Findings from a structural brain imaging substudy of older participants, however, support a possible relationship between platelet decline and reduced gray matter.

Keywords

HIV HIV dementia Hematologic Volumetric MRI Platelets 

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Copyright information

© Journal of NeuroVirology, Inc. 2011

Authors and Affiliations

  • Ann B. Ragin
    • 1
    • 8
  • Gypsyamber D’Souza
    • 2
  • Sandra Reynolds
    • 2
  • Eric Miller
    • 3
  • Ned Sacktor
    • 4
  • Ola A. Selnes
    • 4
  • Eileen Martin
    • 5
  • Barbara R. Visscher
    • 6
  • James T. Becker
    • 7
  1. 1.Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Johns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Semel Institute for NeuroscienceUniversity of California Los AngelesLos AngelesUSA
  4. 4.The Johns Hopkins University School of MedicineBaltimoreUSA
  5. 5.University of Illinois at ChicagoChicagoUSA
  6. 6.School of Public HealthUniversity of California Los AngelesLos AngelesUSA
  7. 7.University of Pittsburgh School of MedicinePittsburghUSA
  8. 8.Department of RadiologyNorthwestern UniversityChicagoUSA

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