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We set out to test the hypothesis that greater brain ageing will be observed in people with HIV (PWH) and those who engage in heavy episodic drinking (HED), with their combined effects being especially detrimental in cognitive control brain networks. We correlated measures of "brain age gap" (BAG) and neurocognitive impairment in participants with and without HIV and HED. Sixty-nine participants were recruited from a community health centre in Cape Town: HIV - /HED - (N = 17), HIV + /HED - (N = 14), HIV - /HED + (N = 21), and HIV + /HED + (N = 17). Brain age was modelled using structural MRI features from the whole brain or one of six brain regions. Linear regression models were employed to identify differences in BAG between patient groups and controls. Associations between BAG and clinical data were tested using bivariate statistical methods. Compared to controls, greater global BAG was observed in heavy drinkers, both with (Cohen's d = 1.52) and without (d = 1.61) HIV. Differences in BAG between HED participants and controls were observed for the cingulate and parietal cortex, as well as subcortically. A larger BAG was associated with higher total drinking scores but not nadir CD4 count or current HIV viral load. The association between heavy episodic drinking and BAG, independent of HIV status, points to the importance of screening for alcohol use disorders in primary care. The relatively large contribution of cognitive control brain regions to BAG highlights the utility of assessing the contribution of different brain regions to brain age.

IntroAlthough it has been suggested that the hippocampus and amygdala (HA) are involved in the neurobiology of obsessive-compulsive disorder (OCD), volumetric findings have been inconsistent. Furthermore, the HA consist of heterogenous anatomic units with specific functions and cytoarchitecture, and little work has been undertaken on the volumetry of these subfields in OCD.MethodsT1-weighted images from 381 patients with OCD and 338 healthy controls (HCs) from the OCD Brain Imaging Consortium were segmented to produce twelve hippocampal subfields and nine amygdala subfields using FreeSurfer 6.0. We assessed between-group differences in subfield volume using a mixed-effects model adjusted for age, quadratic effects of age, sex, site, and whole HA volume. Given evidence of confounding effects of clinical characteristics on brain volumes in OCD, we also performed subgroup analyses to examine subfield volume in relation to comorbid anxiety and depression, medication status, and symptom severity.ResultsPatients with OCD and HCs did not significantly differ in HA subfield volume. However, medicated patients with OCD had significantly smaller hippocampal dentate gyrus (pFDR=0.042,d=-0.26) and molecular layer (pFDR=0.042, d=-0.29) and larger lateral (pFDR=0.049,d=0.23) and basal (pFDR=0.049,d=0.25) amygdala subfields than HCs. Unmedicated patients had significantly smaller hippocampal CA1 (pFDR=0.016, d=-0.28) than HCs. No association was detected between any subfield volume and OCD severity.ConclusionDifferences in HA subfields between OCD and HCs are dependent on medication status, in line with previous work on other brain volumetric alterations in OCD. This emphasizes the importance of considering psychotropic medication in neuroimaging studies of OCD.

Purpose of the review By reviewing the most recent common mental health disorders (CMHD) studies in people living with HIV (PLWH) (2018-2020), this review discusses the prevalence of CMHD, factors associated with CMHD in PLWH, mental health in PLWH from vulnerable groups, the impact of CMHD on HIV disease progression and adherence to antiretroviral therapy and the efficacy of different treatment approaches. Recent findings After screening for eligibility 142 studies were included in the final systematic review. Only 27% of studies were conducted in Sub-Saharan Africa, which carries the highest burn of HIV disease globally. Despite the well-established increased risk of CMHD in PLWH, the current prevalence remains high, with studies reporting 28%-62% of PLWH having mental health symptoms. Conclusion Despite the significant challenges that CMHDs present to successful HIV treatment, there are many mental health treatments and interventions which can improve outcomes in PLWH and opportunities to task-shift and integrate mental health care with HIV care. Supplementary Information The online version contains supplementary material available at 10.1007/s11904-021-00583-w.

This study aimed to assess the association of childhood trauma, stressful life events and HIV stigma with mental health in South African adolescents from the Cape Town Adolescent Antiretroviral Cohort (CTAAC). The Childhood Trauma Questionnaire, Life Events Questionnaire and the HIV Stigma Scale for South African Adolescents Living with HIV was used to assess childhood trauma, stressful life events and stigma in adolescents living with perinatally acquired HIV and healthy controls enrolled in the CTAAC. These measures were associated with mental health outcomes including the Beck-Youth Inventories, Child Behaviour Checklist, Columbian Impairment Scale, Childrens Motivation Scale, Conners Scale for Attention Deficit Hyperactivity Disorder using Pearson correlations and self-reported alcohol use, using Spearman-rank correlation. 63.7% of adolescents reported at least one childhood trauma on the CTQ. Significant associations were reported between CTQ measures and Beck-Youth Inventories. Emotional abuse was associated with anxiety, anger, depression and disruptive behaviour. Emotional neglect was associated with poor self-concept and disruptive behaviour. LEQ total score was significantly associated with Beck-Youth Inventories including anxiety, depression, anger and disruptive behaviour scales. HIV stigma was significantly associated with Beck-Youth Inventories including depression, anger and disruptive behaviour. Childhood trauma, stressful life events and HIV stigma in South African adolescents are associated with anxiety, depression, anger, disruptive-behaviour and poor self-concept. This study highlights the importance of enquiring about exposure to a variety of traumas, particularly those commonly experienced by South African adolescents. In addition, it is important to understand the impact of trauma exposure on each individuals mental health and functioning.

BackgroundChronic HIV infection and alcohol use have been associated with brain changes and neurocognitive impairment. However, their combined effects are less well studied. We correlated measures of “brain age gap” (BAG) and neurocognitive impairment in participants with and without HIV/AIDS and heavy episodic drinking (HED). We predicted that BAG will be greater in PWH who engage in HED and that these effects will be particularly pronounced in frontoparietal and subcortical regions.Method69 participants were recruited from a community health centre in Cape Town: HIV-/HED-(N = 17), HIV+/HED- (N = 14), HIV-/HED+ (N = 21), and HIV+/HED+ (N = 17). Brain age gap (BAG) was derived from thickness, area and volumetric measurements from the whole brain or one of six brain regions. Linear regression models were employed to identify differences in BAG between patient groups and controls. Associations between BAG and clinical indicators of HIV and HED status were also tested using bivariate statistical methods.ResultsCompared to controls, greater whole brain BAG was observed in HIV-/HED+ (Cohen’s d = 1.61, p < 0.001), and HIV+/HED+ (d = 1.52, p = 0.005) participants. Differences in BAG between patients and controls were observed subcortically, as for the cingulate and the parietal cortex. An exploratory analysis revealed that higher relative brain ageing in HED participants with the highest drinking scores (W = 66, p = 0.036) but did not vary as a function of nadir CD4 count or current HIV viral load.ConclusionThe association between heavy episodic drinking and BAG, independent of HIV status, points to the importance of screening for and targeting alcohol use disorders in primary care. Our findings also point to the utility of assessing the contribution of brain regions to the BAG.

Highlights • Inflammatory markers were lower in mothers living with HIV. • Inflammatory markers were lower in HIV-exposed uninfected infants and children. • Early life immune markers predicted impaired motor function at 2 years of age., HIV-exposed uninfected (HEU) children may have altered immune regulation and poorer neurodevelopment outcomes compared to their HIV-unexposed (HU) counterparts. However, studies investigating the association of maternal and infant inflammation with neurodevelopment in HEU children are limited and longitudinal data are lacking. This study investigated serum inflammatory markers in women living with HIV vs. HIV-uninfected women during pregnancy and in their children, as well as associations with neurodevelopmental outcomes at two years of age in an African birth cohort study. A sub-group of mother–child dyads from the Drakenstein Child Health Study had serum inflammatory markers measured at ≈26 week’s gestation (n = 77 HIV-infected mothers; n = 190 HIV-uninfected mothers), at 6–10 weeks (n = 63 HEU infants and n = 159 HU infants) and at 24–28 months (n = 77 HEU children and n = 190 HU children). Serum inflammatory markers [granulocyte–macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ), interleukin IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12p70, IL-13, tumor necrosis factor-α (TNF-α), neutrophil gelatinase-associated lipocalin (NGAL) and metalloproteinase-9 (MMP-9)] were analyzed with a multiplex bead array and ELISA assays. The Bayley Scales of Infant and Toddler Development, third edition, was used to assess neurodevelopment at 24–28 months. After correcting for multiple comparisons, HIV infection during pregnancy was associated with lower serum levels of inflammatory markers in mothers at 26 weeks gestation (GM-CSF and MMP-9, p

Ear tagging is perceived as less painful or stressful than tattooing and therefore is generally considered less harmful or costly to welfare. However, ear tags are more difficult to read than tattoos and can fall out, and mice usually require restraint for the tag numbers to be read accurately. We assessed the welfare and scientific implications of tattooing by using a commercial device compared with restraint in a device versus ear tagging. Male and female BALB/c mice (n = 32) underwent procedures after 1 wk of tail or nonaversive (tunnel) handling to determine whether tunnel handling reduced anxiety. Pain was evaluated using both the Mouse Grimace Scale (MGS) and manual and automated behavior analyses; light–dark preference testing and voluntary interaction with the handler's hand were used to assess anxiety. Tail inflammation after tattooing was quantified using bioluminescent imaging, and ear tag and tattoo misidentification rates were estimated from volunteer staff records. Tunnel handling reduced anxiety compared with tail handling. According to the MGS, tattooing was not more painful than ear tagging but caused significant tail inflammation and more agitation and anxiety. However, all tattoos were read correctly without handling, whereas all ear tagged mice needed restraint, and at least 25% of the tag codes were misread. Handling stress together with identification errors at this rate represent potentially serious concerns regarding the scientific integrity of data from studies using ear tagging. These concerns are unlikely to arise with tattooing. Although tattooing was stressful, so were restraint and ear tagging. However, considering the other major advantages of tattooing, the total costs associated with tattooing were not substantially greater than for ear tagging.