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. 2023 May 1;37(6):861-869.
doi: 10.1097/QAD.0000000000003496. Epub 2023 Jan 27.

Brain volumetrics differ by Fiebig stage in acute HIV infection

Jacob Bolzenius  1 , Carlo Sacdalan  2 , Lishomwa C Ndhlovu  3 , Napapon Sailasuta  4 , Lydie Trautmann  5 , Somporn Tipsuk  2 , Trevor A Crowell  6   7 , Duanghathai Suttichom  2 , Donn J Colby  6   7 , Nittaya Phanuphak  2 , Phillip Chan  8 , Thomas Premeaux  3 , Eugène Kroon  2 , Sandhya Vasan  6   7 , Denise C Hsu  6   7 , Victor Valcour  9 , Jintanat Ananworanich  10 , Merlin L Robb  6   7 , Julie A Ake  5 , Kilian M Pohl  11 , Somchai Sriplienchan  2 , Serena Spudich  8 , Robert Paul  1 ; RV254/SEARCH010, RV304/SEARCH013 Study Teams
Affiliations

Brain volumetrics differ by Fiebig stage in acute HIV infection

Jacob Bolzenius et al. AIDS. .

Abstract

Objective: People with chronic HIV exhibit lower regional brain volumes compared to people without HIV (PWOH). Whether imaging alterations observed in chronic infection occur in acute HIV infection (AHI) remains unknown.

Design: Cross-sectional study of Thai participants with AHI.

Methods: One hundred and twelve Thai males with AHI (age 20-46) and 18 male Thai PWOH (age 18-40) were included. Individuals with AHI were stratified into early (Fiebig I-II; n = 32) and late (Fiebig III-V; n = 80) stages of acute infection using validated assays. T1-weighted scans were acquired using a 3 T MRI performed within five days of antiretroviral therapy (ART) initiation. Volumes for the amygdala, caudate nucleus, hippocampus, nucleus accumbens, pallidum, putamen, and thalamus were compared across groups.

Results: Participants in late Fiebig stages exhibited larger volumes in the nucleus accumbens (8% larger; P = 0.049) and putamen (19%; P < 0.001) when compared to participants in the early Fiebig. Compared to PWOH, participants in late Fiebig exhibited larger volumes of the amygdala (9% larger; P = 0.002), caudate nucleus (11%; P = 0.005), nucleus accumbens (15%; P = 0.004), pallidum (19%; P = 0.001), and putamen (31%; P < 0.001). Brain volumes in the nucleus accumbens, pallidum, and putamen correlated modestly with stimulant use over the past four months among late Fiebig individuals ( P s < 0.05).

Conclusions: Findings indicate that brain volume alterations occur in acute infection, with the most prominent differences evident in the later stages of AHI. Additional studies are needed to evaluate mechanisms for possible brain disruption following ART, including viral factors and markers of neuroinflammation.

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Conflict of interest statement

Conflicts of Interest: V.V. reports grants from NIH, other from UCSF, during the conduct of the study; personal fees from ViiV Healthcare, personal fees from Merck, outside the submitted work. L.C.N. reports being a recipient of grants from the NIH during the conduct of this study and has received consulting fees from work as a scientific advisor for AbbVie, ViiV Healthcare and Cytodyn and service on the Board of Cytodyn outside of the submitted work. S.S. reports grants from NIH – NIMH & NINDS, during the conduct of the study; nonfinancial support from ViiV Healthcare, outside the submitted work. R.P. reports grants from NIH – NIMH. KMP reports grants from NIH NIMH and NIAAA, and funding from Stanford Institute for Human-Centered Artificial Intelligence (HAI). For the remaining authors no disclosures were declared.

Figures

Figure 1.
Figure 1.
Regional brain volumes exhibiting significant differences among subgroups.
See this image and copyright information in PMC

References

    1. Chang L, Ernst T, Speck O, Grob CS. Additive effects of HIV and chronic methamphetamine use on brain metabolite abnormalities. Am J Psychiatry 2005; 162(2):361–369. - PMC - PubMed
    1. Ances BM, Ortega M, Vaida F, Heaps J, Paul R. Independent effects of HIV, aging, and HAART on brain volumetric measures. J Acquir Immune Defic Syndr 2012; 59(5):469–477. - PMC - PubMed
    1. Becker JT, Sanders J, Madsen SK, Ragin A, Kingsley L, Maruca V, et al. Subcortical brain atrophy persists even in HAART-regulated HIV disease. Brain Imaging Behav 2011; 5(2):77–85. - PMC - PubMed
    1. Nir TM, Jahanshad N, Ching CRK, Cohen RA, Harezlak J, Schifitto G, et al. Progressive brain atrophy in chronically infected and treated HIV+ individuals. J Neurovirol 2019; 25(3):342–353. - PMC - PubMed
    1. Paul RH, Cho K, Belden A, Carrico AW, Martin E, Bolzenius J, et al. Cognitive Phenotypes of HIV Defined Using a Novel Data-driven Approach. J Neuroimmune Pharmacol 2022. - PMC - PubMed

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