Association between brain volumes and HAND in cART-naïve HIV+ individuals from Thailand

Abstract

This study aimed to determine the effects of human immunodeficiency virus (HIV) on brain structure in HIV-infected individuals with and without HIV-associated neurocognitive disorders (HAND). Twenty-nine HIV-uninfected controls, 37 HIV+, treatment-naïve, individuals with HAND (HIV+HAND+; 16 asymptomatic neurocognitive impairment (ANI), 12 mild neurocognitive disorder (MND), and 9 HIV-associated dementia HAD), and 37 HIV+, treatment-naïve, individuals with normal cognitive function (HIV+HAND−) underwent magnetic resonance imaging (MRI) and neuropsychological assessment. The HIV-infected participants had a mean (SD) age of 35 (7) years, mean (interquartile range (IQR)) CD4 count of 221 (83–324), and mean (IQR) log10 plasma viral load of 4.81 (4.39–5.48). Six regions of interest were selected for analyses including total and subcortical gray matter, total white matter, caudate, corpus callosum, and thalamus. The HIV+/HAND+ group exhibited significantly smaller brain volumes compared to the HIV-uninfected group in subcortical gray and total gray matter; however, there were no statistically significant differences in brain volumes between the HIV+HAND+ and HIV+HAND− groups or between HIV+/HAND− and controls. CD4 count at time of combination antiretroviral therapy (cART) initiation was associated with total and subcortical gray matter volumes but not with cognitive measures. Plasma viral load correlated with neuropsychological performance but not brain volumes. The lack of significant differences in brain volumes between HIV+HAND+ and HIV+HAND− suggests that brain atrophy is not a sensitive measure of HAND in subjects without advanced immunosuppression. Alternatively, current HAND diagnostic criteria may not sufficiently distinguish patients based on MRI measures of brain volumes.

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Acknowledgments

We would like to express our deepest gratitude to SEARCH 007 and 011 protocol teams: Nittaya Phanuphak MD, Nitiya Chomchey, Somprartthana Rattanamanee, and Pairoa Praihirunkit from SEARCH/TRCARC; Nijasri Charnnarong MD and Sukalaya Lerdlum MD from Chulalongkorn University; Yotin Chinvarun MD from Phramongkutklao Medical Center; Mark de Souza PhD MPH, Alexandra Schuetz PhD, and Rapee Trichavaroj from the Armed Forces Research Institute of Medical Sciences; Supunee Jirajariyavej MD from Taksin Hospital; Bruce Shiramizu MD from the University of Hawai’i; and Carol Liu, Elijah Mun, Stephanie Chiao, Katherine Clifford, BA, and Lauren Wendelken from UCSF,

This work was supported by NIH grants R01-NS053359 (SR) and R01-NS061696 (VV).

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Correspondence to Jodi M. Heaps.

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Heaps, J.M., Sithinamsuwan, P., Paul, R. et al. Association between brain volumes and HAND in cART-naïve HIV+ individuals from Thailand. J. Neurovirol. 21, 105–112 (2015). https://doi.org/10.1007/s13365-014-0309-8

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Keywords

  • HIV-associated neurocognitive disorder
  • Neuroimaging
  • Thailand
  • Cognition