Regional areas and widths of the midsagittal corpus callosum among HIV-infected patients on stable antiretroviral therapies
| Autor: | Giovanni Schifitto, Daniel McCaffrey, Scott Letendre, Jared Conley, Constantine Yiannoutsos, Jeffrey Dewey, Thomas B. Campbell, Troy Russell, Mark Fiecas, Jianhui Zhong, Y. Tso, Janetta Matesan, Mehul Sampat, Bradford A. Navia, Ronald A. Cohen, Michelle Gaugh, Mark A. Brown, Jeffrey R. Alger, Jaroslaw Harezlak, Daniel Branson, Michael Taylor, Elyse J. Singer, S. Paulose, Joseph W. Hogan, C. Tripoli, David F. Tate, Charles R.G. Guttmann, Eric S. Daar, Deborah McMahon, Erin D. Bigler |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
CD4-Positive T-Lymphocytes Male Cart medicine.medical_specialty AIDS Dementia Complex Neurology Anti-HIV Agents HIV Infections Neuroimaging Context (language use) Corpus callosum Severity of Illness Index Article Corpus Callosum White matter Cellular and Molecular Neuroscience Cognition Stable Disease Antiretroviral Therapy Highly Active Virology Internal medicine medicine Humans Longitudinal Studies Immunosuppression Therapy business.industry HIV Middle Aged Viral Load Magnetic Resonance Imaging CD4 Lymphocyte Count medicine.anatomical_structure Case-Control Studies Immunology Linear Models RNA Viral Female Neurology (clinical) Complication business |
| Zdroj: | Journal of NeuroVirology. 17:368-379 |
| ISSN: | 1538-2443 1355-0284 |
| Popis: | Recent reports suggest that a growing number of human immunodeficiency virus (HIV)-infected persons show signs of persistent cognitive impairment even in the context of combination antiretroviral therapies (cART). The basis for this finding remains poorly understood as there are only a limited number of studies examining the relationship between CNS injury, measures of disease severity, and cognitive function in the setting of stable disease. This study examined the effects of HIV infection on cerebral white matter using quantitative morphometry of the midsagittal corpus callosum (CC) in 216 chronically infected participants from the multisite HIV Neuroimaging Consortium study currently receiving cART and 139 controls. All participants underwent MRI assessment, and HIV-infected subjects also underwent measures of cognitive function and disease severity. The midsagittal slice of the CC was quantified using two semi-automated procedures. Group comparisons were accomplished using ANOVA, and the relationship between CC morphometry and clinical covariates (current CD4, nadir CD4, plasma and CSF HIV RNA, duration of HIV infection, age, and ADC stage) was assessed using linear regression models. HIV-infected patients showed significant reductions in both the area and linear widths for several regions of the CC. Significant relationships were found with ADC stage and nadir CD4 cell count, but no other clinical variables. Despite effective treatment, significant and possibly irreversible structural loss of the white matter persists in the setting of chronic HIV disease. A history of advanced immune suppression is a strong predictor of this complication and suggests that antiretroviral intervention at earlier stages of infection may be warranted. |
| Databáze: | OpenAIRE |
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