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Topographies of Cortical and Subcortical Volume Loss in HIV and Aging in the cART Era.
- Source :
-
Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2016 Dec 01; Vol. 73 (4), pp. 374-383. - Publication Year :
- 2016
-
Abstract
- Objectives: Studies of HIV-associated brain atrophy often focus on a priori brain regions of interest, which can introduce bias. A data-driven, minimally biased approach was used to analyze changes in brain volumetrics associated with HIV and their relationship to aging, viral factors, combination antiretroviral therapy (cART), and gender, and smoking.<br />Design: A cross-sectional study of 51 HIV-uninfected (HIV-) and 146 HIV-infected (HIV+) participants.<br />Methods: Structural MRI of participants was analyzed using principal component analysis (PCA) to reduce dimensionality and determine topographies of volumetric changes. Neuropsychological (NP) assessment was examined using global and domain-specific scores. The effects of HIV disease factors (eg, viral load, CD4, etc.) on brain volumes and neuropsychological were investigated using penalized regression (LASSO).<br />Results: Two components of interest were visualized using principal component analysis. An aging effect predominated for both components. The first component, a cortically weighted topography, accounted for a majority of variance across participants (43.5% of variance) and showed independent effects of HIV and smoking. A secondary, subcortically weighted topography (4.6%) showed HIV-status accentuated age-related volume loss. In HIV+ patients, the cortical topography correlated with global neuropsychological scores and nadir CD4, whereas subcortical volume loss was associated with recent viral load.<br />Conclusions: Cortical regions showed the most prominent volumetric changes because of aging and HIV. Within HIV+ participants, cortical volumes were associated with immune history, whereas subcortical changes correlated with current immune function. Cognitive function was primarily associated with cortical volume changes. Observed volumetric changes in chronic HIV+ patients may reflect both past infection history and current viral status.<br />Competing Interests: The authors, Anika Guha, Matthew R. Brier, Mario Ortega, Elizabeth Westerhaus, Brittany Nelson, and Beau M. Ances, declare that they have no conflict of interest.
- Subjects :
- AIDS Dementia Complex drug therapy
AIDS Dementia Complex pathology
Adolescent
Adult
Aged
Case-Control Studies
Cross-Sectional Studies
Drug Therapy, Combination
Female
Humans
Male
Middle Aged
Organ Size
Principal Component Analysis
Young Adult
Aging
Anti-HIV Agents adverse effects
Anti-HIV Agents therapeutic use
Cerebral Cortex pathology
HIV Infections pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1944-7884
- Volume :
- 73
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of acquired immune deficiency syndromes (1999)
- Publication Type :
- Academic Journal
- Accession number :
- 27454251
- Full Text :
- https://doi.org/10.1097/QAI.0000000000001111