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Regional brain volumetric changes despite 2 years of treatment initiated during acute HIV infection.
Kallianpur, Kalpana J; Jahanshad, Neda; Sailasuta, Napapon; Benjapornpong, Khunthalee; Chan, Phillip; Pothisri, Mantana; Dumrongpisutikul, Netsiri; Laws, Elizabeth; Ndhlovu, Lishomwa C; Clifford, Katherine M; Paul, Robert; Jagodzinski, Linda; Krebs, Shelly; Ananworanich, Jintanat; Spudich, Serena; Valcour, Victor.
Afiliação
  • Kallianpur KJ; University of Hawaii at Manoa, Honolulu, Hawaii, USA.
  • Jahanshad N; University of Southern California, Marina del Rey, California, USA.
  • Sailasuta N; University of Hawaii at Manoa, Honolulu, Hawaii, USA.
  • Benjapornpong K; SEARCH Thailand, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
  • Chan P; SEARCH Thailand, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
  • Pothisri M; Chulalongkorn University Medical Center, Bangkok, Thailand.
  • Dumrongpisutikul N; Chulalongkorn University Medical Center, Bangkok, Thailand.
  • Laws E; University of Hawaii at Manoa, Honolulu, Hawaii, USA.
  • Ndhlovu LC; University of Hawaii at Manoa, Honolulu, Hawaii, USA.
  • Clifford KM; University of California at San Francisco, San Francisco, California, USA.
  • Paul R; University of Missouri at St. Louis, St. Louis, Missouri, USA.
  • Jagodzinski L; Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
  • Krebs S; Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
  • Ananworanich J; Henry M. Jackson Foundation, Silver Spring, Maryland, USA.
  • Spudich S; University of Hawaii at Manoa, Honolulu, Hawaii, USA.
  • Valcour V; Walter Reed Army Institute of Research, Silver Spring, Maryland, USA.
AIDS ; 34(3): 415-426, 2020 03 01.
Article em En | MEDLINE | ID: mdl-31725432
OBJECTIVE: To assess changes in regional brain volumes after 24 months among individuals who initiated combination antiretroviral therapy (cART) within weeks of HIV exposure. DESIGN: Prospective cohort study of Thai participants in the earliest stages of HIV-1infection. METHODS: Thirty-four acutely HIV-infected individuals (AHI; Fiebig I-V) underwent brain magnetic resonance (MR) imaging and MR spectroscopy at 1.5 T and immediately initiated cART. Imaging was repeated at 24 months. Regional brain volumes were quantified using FreeSurfer's longitudinal pipeline. Voxel-wise analyses using tensor-based morphometry (TBM) were conducted to verify regional assessments. Baseline brain metabolite levels, blood and cerebrospinal fluid biomarkers assessed by ELISA, and peripheral blood monocyte phenotypes measured by flow cytometry were examined as predictors of significant volumetric change. RESULTS: Participants were 31 ±â€Š8 years old. The estimated mean duration of infection at cART initiation was 15 days. Longitudinal analyses revealed reductions in volumes of putamen (P < 0.001) and caudate (P = 0.006). TBM confirmed significant atrophy in the putamen and caudate, and also in thalamic and hippocampal regions. In exploratory post-hoc analyses, higher baseline frequency of P-selectin glycoprotein ligand-1 (PSGL-1)-expressing total monocytes correlated with greater caudate volumetric decrease (ρ = 0.67, P = 0.017), whereas the baseline density of PSGL-1-expressing inflammatory (CD14CD16) monocytes correlated with putamen atrophy (ρ = 0.65, P = 0.022). CONCLUSION: Suppressive cART initiated during AHI may not prevent brain atrophy. Volumetric decrease appears greater than expected age-related decline, although examination of longitudinal change in demographically similar HIV-uninfected Thai individuals is needed. Mechanisms underlying progressive HIV-related atrophy may include early activation and enhanced adhesive and migratory capacity of circulating monocyte populations.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encéfalo / Infecções por HIV Tipo de estudo: Observational_studies Limite: Adult / Humans / Male País/Região como assunto: Asia Idioma: En Revista: AIDS Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Encéfalo / Infecções por HIV Tipo de estudo: Observational_studies Limite: Adult / Humans / Male País/Região como assunto: Asia Idioma: En Revista: AIDS Assunto da revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos País de publicação: Reino Unido