Brain aging and cardiovascular factors in HIV: a longitudinal volume and shape MRI study. (1st May 2022)

• Record Type: Journal Article
• Authors: Jakabek, David; Rae, Caroline D.; Brew, Bruce J.; Cysique, Lucette A.
• Is Part Of: AIDS. Volume 36:Number 6(2022)
• Page Start: 785
• Page End: 794
• Publication Date: 2022-05-01
• Subjects: HIV -- HIV-associated neurocognitive disorder -- longitudinal -- neuroimaging -- shape analysis; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome; AIDS (Disease); Periodicals; Periodicals; 616.9792005
• DOI: 10.1097/QAD.0000000000003165
• Languages: English
• ISSNs: 0269-9370

Abstract

Abstract : Objective: We aimed to examine the relative contributions of HIV infection, age, and cardiovascular risk factors to subcortical brain atrophy in people with HIV (PWH). Design: Longitudinal observational study. Methods: Virally suppressed PWH with low neuropsychological confounds ( n = 75) and demographically matched HIV-negative controls ( n = 31) completed baseline and 18-month follow-up MRI scans, neuropsychological evaluation, cardiovascular assessments, and HIV laboratory tests. PWH were evaluated for HIV-associated neurocognitive disorder (HAND). Subcortical volumes were extracted with Freesurfer after removal of white matter hyperintensities. Volumetric and shape analyses were conducted using linear mixed-effect models incorporating interactions between age, time, and each of HIV status, HAND status, HIV disease factors, and cardiovascular markers. Results: Across baseline and follow-up PWH had smaller volumes of most subcortical structures compared with HIV-negative participants. In addition, over time older PWH had a more rapid decline in caudate volumes (P = 0.041), predominantly in the more severe HAND subgroups ( P = 0.042). Higher CD4 + cell counts had a protective effect over time on subcortical structures for older participants with HIV. Increased cardiovascular risk factors were associated with smaller volumes across baseline and follow-up for most structures, although a more rapid decline over time was observed for striatal volumes. There were no significant shape analyses findings. Conclusion: The study demonstrates a three-hit model of general (as opposed to localized) subcortical injury in PWH: HIV infection associated with smaller volumes of most subcortical structures, HIV infection and aging synergy in the striatum, and cardiovascular-related injury linked to early and more rapid striatal atrophy.