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Multicenter Study
. 2011 Jun;17(3):248-57.
doi: 10.1007/s13365-011-0032-7. Epub 2011 May 5.

Clinical factors related to brain structure in HIV: the CHARTER study

Terry L Jernigan  1 , Sarah L Archibald, Christine Fennema-Notestine, Michael J Taylor, Rebecca J Theilmann, Michelle D Julaton, Randy J Notestine, Tanya Wolfson, Scott L Letendre, Ronald J Ellis, Robert K Heaton, Anthony C Gamst, Donald R Franklin Jr, David B Clifford, Ann C Collier, Benjamin B Gelman, Christina Marra, Justin C McArthur, J Allen McCutchan, Susan Morgello, David M Simpson, Igor Grant; CHARTER Group
Collaborators, Affiliations
Multicenter Study

Clinical factors related to brain structure in HIV: the CHARTER study

Terry L Jernigan et al. J Neurovirol. 2011 Jun.

Abstract

Despite the widening use of combination antiretroviral therapy (ART), neurocognitive impairment remains common among HIV-infected (HIV+) individuals. Associations between HIV-related neuromedical variables and magnetic resonance imaging indices of brain structural integrity may provide insight into the neural bases for these symptoms. A diverse HIV+ sample (n = 251) was studied through the CNS HIV Antiretroviral Therapy Effects Research initiative. Multi-channel image analysis produced volumes of ventricular and sulcal cerebrospinal fluid (CSF), cortical and subcortical gray matter, total cerebral white matter, and abnormal white matter. Cross-sectional analyses employed a series of multiple linear regressions to model each structural volume as a function of severity of prior immunosuppression (CD4 nadir), current CD4 count, presence of detectable CSF HIV RNA, and presence of HCV antibodies; secondary analyses examined plasma HIV RNA, estimated duration of HIV infection, and cumulative exposure to ART. Lower CD4 nadir was related to most measures of the structural brain damage. Higher current CD4, unexpectedly, correlated with lower white and subcortical gray and increased CSF. Detectable CSF HIV RNA was related to less total white matter. HCV coinfection was associated with more abnormal white matter. Longer exposure to ART was associated with lower white matter and higher sulcal CSF. HIV neuromedical factors, including lower nadir, higher current CD4 levels, and detectable HIV RNA, were associated with white matter damage and variability in subcortical volumes. Brain structural integrity in HIV likely reflects dynamic effects of current immune status and HIV replication, superimposed on residual effects associated with severe prior immunosuppression.

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Figures

Fig. 1
Fig. 1
Multi-channel morphometry. Coronal T2 (left), T1 (middle), and segmented (right) images for anterior (top) and posterior (bottom) sections. Volumes include: ventricular (red) and subarachnoid (black) CSF, abnormal (orange) and total (white + orange) white matter, cortical (blue) and subcortical (turquoise) gray matter
Fig. 2
Fig. 2
Nadir CD4 and morphometric volumes. Partial correlation scatterplots (plots of partial residuals) show the relationship between square root transformed CD4 nadir and log-transformed morphometric volumes, after adjusting for all other variables in the regression models
Fig. 3
Fig. 3
Current CD4 and morphometric volumes. Partial correlation scatterplots show the relationship between square root transformed current CD4 and log-transformed morphometric volumes, after adjusting for all other variables in the regression models
See this image and copyright information in PMC

References

    1. Antinori A, Arendt G, Becker JT, Brew BJ, Byrd DA, Cherner M, Clifford DB, Cinque P, Epstein LG, Goodkin K, Gisslen M, Grant I, Heaton RK, Joseph J, Marder K, Marra CM, McArthur JC, Nunn M, Price RW, Pulliam L, Robertson KR, Sacktor N, Valcour V, Wojna VE. Updated research nosology for HIV-associated neurocognitive disorders. Neurology. 2007;69:1789–1799. - PMC - PubMed
    1. Archibald SL, Masliah E, Fennema-Notestine C, Marcotte TD, Ellis RJ, McCutchan JA, Heaton RK, Grant I, Mallory M, Miller A, Jernigan TL. Correlation of in vivo neuroimaging abnormalities with postmortem human immunodeficiency virus encephalitis and dendritic loss. Arch Neurol. 2004;61:369–376. - PubMed
    1. Aylward EH, Brettschneider PD, McArthur JC, Harris GJ, Schlaepfer TE, Henderer JD, Barta PE, Tien AY, Pearlson GD. Magnetic resonance imaging measurement of gray matter volume reductions in HIV dementia. Am J Psychiatry. 1995;152:987–994. - PubMed
    1. Cardenas V, Meyerhoff D, Studholme C, Kornak J, Rothlind J, Lampiris H, Neuhaus J, Grant R, Chao L, Truran D, Weiner M. Evidence for ongoing brain injury in human immunodeficiency virus-positive patients treated with antiretroviral therapy. J Neurovirol. 2009;15(4):324–333. - PMC - PubMed
    1. Chang L, Speck O, Miller EN, Braun J, Jovicich J, Koch C, Itti L, Ernst T. Neural correlates of attention and working memory deficits in HIV patients. Neurology. 2001;57:1001–1007. - PubMed

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