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Review
. 2019 Oct;9(5):433-442.
doi: 10.1212/CPJ.0000000000000637.

Brain structure of perinatally HIV-infected patients on long-term treatment: A systematic review

Malon Van den Hof  1 , Anne Marleen Ter Haar  1 , Matthan W A Caan  1 , Rene Spijker  1 , Johanna H van der Lee  1 , Dasja Pajkrt  1
Affiliations
Review

Brain structure of perinatally HIV-infected patients on long-term treatment: A systematic review

Malon Van den Hof et al. Neurol Clin Pract. 2019 Oct.

Abstract

Objective: We aim to give an overview of the available evidence on brain structure and function in PHIV-infected patients (PHIV+) using long-term combination antiretroviral therapy (cART) and how differences change over time.

Methods: We conducted an electronic search using MEDLINE, Embase, and PsycINFO. We used the following selection criteria: cohort and cross-sectional studies that reported on brain imaging differences between PHIV+ of all ages who used cART for at least six months before neuroimaging and HIV-negative controls. Two reviewers independently selected studies, performed data extraction, and assessed quality of studies.

Results: After screening 1500 abstracts and 343 full-text articles, we identified 19 eligible articles. All included studies had a cross-sectional design and used MRI with different modalities: structural MRI (n = 7), diffusion tensor imaging (DTI) (n = 6), magnetic resonance spectroscopy (n = 5), arterial spin labeling (n = 1), and resting-state functional neuroimaging (n = 1). Studies showed considerable methodological limitations and heterogeneity, preventing us to perform meta-analyses. DTI data on white matter microstructure suggested poorer directional diffusion in cART-treated PHIV+ compared with controls. Other modalities were inconclusive.

Conclusion: Evidence may suggest brain structure and function differences in the population of PHIV+ on long-term cART compared with the HIV-negative population. Because of a small study population, and considerable heterogeneity and methodological limitations, the extent of brain structure and function differences on neuroimaging between groups remains unknown.

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Figures

Figure
Figure. Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram
cART = combination antiretroviral therapy.
See this image and copyright information in PMC

Comment in

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