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. 2017 May:62:100-109.
doi: 10.1016/j.bbi.2017.01.004. Epub 2017 Jan 10.

Lower total and regional grey matter brain volumes in youth with perinatally-acquired HIV infection: Associations with HIV disease severity, substance use, and cognition

C Paula Lewis-de Los Angeles  1 , Paige L Williams  2 , Yanling Huo  2 , Shirlene D Wang  3 , Kristina A Uban  4 , Megan M Herting  4 , Kathleen Malee  3 , Ram Yogev  5 , John G Csernansky  3 , Sharon Nichols  6 , Russell B Van Dyke  7 , Elizabeth R Sowell  8 , Lei Wang  9 ; Pediatric HIV/AIDS Cohort Study (PHACS) and the Pediatric Imaging, Neurocognition, and Genetics (PING) Study
Affiliations

Lower total and regional grey matter brain volumes in youth with perinatally-acquired HIV infection: Associations with HIV disease severity, substance use, and cognition

C Paula Lewis-de Los Angeles et al. Brain Behav Immun. 2017 May.

Abstract

Despite improved survival due to combination antiretroviral therapy (cART), youth with perinatally-acquired HIV (PHIV) show cognitive deficits and developmental delay at increased rates. HIV affects the brain during critical periods of development, and the brain may be a persistent reservoir for HIV due to suboptimal blood brain barrier penetration of cART. We conducted structural magnetic resonance imaging (sMRI) and cognitive testing in 40 PHIV youth (mean age=16.7years) recruited from the NIH Pediatric HIV/AIDS Cohort Study (PHACS) who are part of the first generation of PHIV youth surviving into adulthood. Historical and current HIV disease severity and substance use measures were also collected. Total and regional cortical grey matter brain volumes were compared to a group of 334 typically-developing, HIV-unexposed and uninfected youth (frequency-matched for age and sex) from the Pediatric Imaging, Neurocognition, and Genetics (PING) study (mean age=16.1years). PHIV youth had smaller (2.8-5.1%) total and regional grey matter volumes than HIV-unexposed and uninfected youth, with smallest volumes seen among PHIV youth with higher past peak viral load (VL) and recent unsuppressed VL. In PHIV youth, worse cognitive performance correlated with smaller volumes. This pattern of smaller grey matter volumes suggests that PHIV infection may influence brain development and underlie cognitive dysfunction seen in this population. Among PHIV youth, smaller volumes were also linked to substance use (alcohol use: 9.0-13.4%; marijuana use: 10.1-16.0%). In this study, collection of substance use information was limited to the PHIV cohort; future studies should also collect substance use information in controls to further address interactions between HIV and substance use on brain volume.

Keywords: Adolescence; Brain; Development; Grey matter; HIV; Magnetic resonance imaging; Neuroimaging; Neuropsychology; Perinatally-acquired.

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Figures

Figure 1
Figure 1
Adjusted Mean Regional Brain Volumes (95% CI) by HIV Infection Status Adjusted models include sex, race, age at scan, caregiver education, annual household income, and intracranial volume. * The unit of brain volume for total grey matter is (× 105 mm3).
Figure 2
Figure 2
Schematic of 10 primary regions of interest (ROI) and volume associations visualized using a Freesurfer template brain
See this image and copyright information in PMC

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