King's College London

Research portal

Structural Brain Abnormalities in Successfully Treated HIV Infection: Associations With Disease and Cerebrospinal Fluid Biomarkers

Research output: Contribution to journalArticle

Rosan A van Zoest, Jonathan Underwood, Davide De Francesco, Caroline A Sabin, James H Cole, Ferdinand W Wit, Matthan W A Caan, Neeltje A Kootstra, Dietmar Fuchs, Henrik Zetterberg, Charles B L M Majoie, Peter Portegies, Alan Winston, David J Sharp, Magnus Gisslén, Peter Reiss, Comorbidity in Relation to AIDS (COBRA) Collaboration

Original languageEnglish
Pages (from-to)69-81
Number of pages13
JournalJournal of Infectious Diseases
Volume217
Issue number1
DOIs
Publication statusPublished - 27 Dec 2017

King's Authors

Abstract

Background: Brain structural abnormalities have been reported in persons living with human immunodeficiency virus (HIV; PLWH) who are receiving suppressive combination antiretroviral therapy (cART), but their pathophysiology remains unclear.

Methods: We investigated factors associated with brain tissue volumes and white matter microstructure (fractional anisotropy) in 134 PLWH receiving suppressive cART and 79 comparable HIV-negative controls, aged ≥45 years, from the Comorbidity in Relation to AIDS cohort, using multimodal neuroimaging and cerebrospinal fluid biomarkers.

Results: Compared with controls, PLWH had lower gray matter volumes (-13.7 mL; 95% confidence interval, -25.1 to -2.2) and fractional anisotropy (-0.0073; 95% confidence interval, -.012 to -.0024), with the largest differences observed in those with prior clinical AIDS. Hypertension and the soluble CD14 concentration in cerebrospinal fluid were associated with lower fractional anisotropy. These associations were independent of HIV serostatus (Pinteraction = .32 and Pinteraction = .59, respectively) and did not explain the greater abnormalities in brain structure in relation to HIV infection.

Conclusions: The presence of lower gray matter volumes and more white matter microstructural abnormalities in well-treated PLWH partly reflect a combination of historical effects of AIDS, as well as the more general influence of systemic factors, such as hypertension and ongoing neuroinflammation. Additional mechanisms explaining the accentuation of brain structure abnormalities in treated HIV infection remain to be identified.

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454