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. 2015 Apr;21(2):105-12.
doi: 10.1007/s13365-014-0309-8. Epub 2015 Jan 21.

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

Jodi M Heaps  1 , Pasiri Sithinamsuwan, Robert Paul, Sukalaya Lerdlum, Mantana Pothisri, David Clifford, Somporn Tipsuk, Stephanie Catella, Edgar Busovaca, James L K Fletcher, Benjamin Raudabaugh, Silvia Ratto-Kim, Victor Valcour, Jintanat Ananworanich; SEARCH 007/011 study groups
Collaborators, Affiliations

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

Jodi M Heaps et al. J Neurovirol. 2015 Apr.

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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Figures

Figure 1
Figure 1
shows scatter plots for the comparison of ROI volumes in the Thalamus, Total Gray matter, and Subcortical gray matter between the HIV−, HIV+HAND+, and HIV+HAND− groups. Significant differences existed between the HIV+HAND+ and HIV− groups only. Lines represent the group means (center) and standard deviations
Figure 1
Figure 1
shows scatter plots for the comparison of ROI volumes in the Thalamus, Total Gray matter, and Subcortical gray matter between the HIV−, HIV+HAND+, and HIV+HAND− groups. Significant differences existed between the HIV+HAND+ and HIV− groups only. Lines represent the group means (center) and standard deviations
Figure 2
Figure 2
shows scatter plots for the comparison ROI volumes between the HIV−, HIV+symptomatic HIV+S; MND and HAD), and HIV+asymptomatic (HIV+A; Normal cognition and ANI) groups. Significant differences were present in the thalamus and subcortical gray ROis between the HIV− and HIV+S groups as well as the HIV− and HIV+A groups. There were no significant differences between the HIV+ groups.
Figure 3
Figure 3
shows the correlations between CD4 count and ROI volumes in the total gray matter and the thalamus for all HIV+ individuals.
See this image and copyright information in PMC

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