Sophie Cohen1, Matthan W A Caan2, Henk-Jan Mutsaerts2, Henriette J Scherpbier2, Taco W Kuijpers2, Peter Reiss2, Charles B L M Majoie2, Dasja Pajkrt2. 1. From the Department of Pediatric Hematology, Immunology and Infectious Diseases (S.C., H.J.S., T.W.K., D.P.), Emma Children's Hospital AMC, Amsterdam; the Department of Radiology (M.W.A.C., H.-J.M., C.B.L.M.M.), the Department of Global Health and Amsterdam Institute of Global Health and Development (P.R.), and the Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA) (P.R.), Academic Medical Centre, University of Amsterdam; and HIV Monitoring Foundation (P.R.), Amsterdam, the Netherlands. s.cohen@amc.nl. 2. From the Department of Pediatric Hematology, Immunology and Infectious Diseases (S.C., H.J.S., T.W.K., D.P.), Emma Children's Hospital AMC, Amsterdam; the Department of Radiology (M.W.A.C., H.-J.M., C.B.L.M.M.), the Department of Global Health and Amsterdam Institute of Global Health and Development (P.R.), and the Department of Internal Medicine, Division of Infectious Diseases, Center for Infection and Immunity Amsterdam (CINIMA) (P.R.), Academic Medical Centre, University of Amsterdam; and HIV Monitoring Foundation (P.R.), Amsterdam, the Netherlands.
Abstract
OBJECTIVE: The current study aims to evaluate the neurologic state of perinatally HIV-infected children on combination antiretroviral therapy and to attain a better insight into the pathogenesis of their persistent neurologic and cognitive deficits. METHODS: We included perinatally HIV-infected children between 8 and 18 years and healthy controls matched for age, sex, ethnicity, and socioeconomic status. All participants underwent a 3.0 T MRI with 3D-T1-weighted, 3D-fluid-attenuated inversion recovery, and diffusion-weighted series for the evaluation of cerebral volumes, white matter hyperintensities (WMH), and white matter (WM) diffusion characteristics. Associations with disease-related parameters and cognitive performance were explored using linear regression models. RESULTS: We included 35 cases (median age 13.8 years) and 37 controls (median age 12.1 years). A lower gray matter and WM volume, more WMH, and a higher WM diffusivity were observed in the cases. Within the HIV-infected children, a poorer clinical, immunologic, and virologic state were negatively associated with volumetric, WMH, and diffusivity markers. CONCLUSIONS: In children with HIV, even when long-term clinically and virologically controlled, we found lower brain volumes, a higher WMH load, and poorer WM integrity compared to matched controls. These differences occur in the context of a poor cognitive performance in the HIV-infected group, and larger, longitudinal studies are needed to increase our understanding of the pathogenesis of cerebral injury in perinatally HIV-infected children.
OBJECTIVE: The current study aims to evaluate the neurologic state of perinatally HIV-infectedchildren on combination antiretroviral therapy and to attain a better insight into the pathogenesis of their persistent neurologic and cognitive deficits. METHODS: We included perinatally HIV-infectedchildren between 8 and 18 years and healthy controls matched for age, sex, ethnicity, and socioeconomic status. All participants underwent a 3.0 T MRI with 3D-T1-weighted, 3D-fluid-attenuated inversion recovery, and diffusion-weighted series for the evaluation of cerebral volumes, white matter hyperintensities (WMH), and white matter (WM) diffusion characteristics. Associations with disease-related parameters and cognitive performance were explored using linear regression models. RESULTS: We included 35 cases (median age 13.8 years) and 37 controls (median age 12.1 years). A lower gray matter and WM volume, more WMH, and a higher WM diffusivity were observed in the cases. Within the HIV-infectedchildren, a poorer clinical, immunologic, and virologic state were negatively associated with volumetric, WMH, and diffusivity markers. CONCLUSIONS: In children with HIV, even when long-term clinically and virologically controlled, we found lower brain volumes, a higher WMH load, and poorer WM integrity compared to matched controls. These differences occur in the context of a poor cognitive performance in the HIV-infected group, and larger, longitudinal studies are needed to increase our understanding of the pathogenesis of cerebral injury in perinatally HIV-infectedchildren.
Authors: C Paula Lewis-de Los Angeles; Paige L Williams; Yanling Huo; Shirlene D Wang; Kristina A Uban; Megan M Herting; Kathleen Malee; Ram Yogev; John G Csernansky; Sharon Nichols; Russell B Van Dyke; Elizabeth R Sowell; Lei Wang Journal: Brain Behav Immun Date: 2017-01-10 Impact factor: 7.217
Authors: Minjie Wu; Omalara Fatukasi; Shaolin Yang; Jeffery Alger; Peter B Barker; Hoby Hetherington; Tae Kim; Andrew Levine; Eileen Martin; Cynthia A Munro; Todd Parrish; Ann Ragin; Ned Sacktor; Eric Seaberg; James T Becker Journal: AIDS Date: 2018-08-24 Impact factor: 4.177
Authors: Emmanuel C Nwosu; Frances C Robertson; Martha J Holmes; Mark F Cotton; Els Dobbels; Francesca Little; Barbara Laughton; Andre van der Kouwe; Ernesta M Meintjes Journal: Metab Brain Dis Date: 2017-12-05 Impact factor: 3.584
Authors: C Paula Lewis-de Los Angeles; Kathryn I Alpert; Paige L Williams; Kathleen Malee; Yanling Huo; John G Csernansky; Ram Yogev; Russell B Van Dyke; Elizabeth R Sowell; Lei Wang Journal: J Pediatric Infect Dis Soc Date: 2016-12 Impact factor: 3.164
Authors: Nicole Phillips; Taryn Amos; Caroline Kuo; Jacqueline Hoare; Jonathan Ipser; Kevin G F Thomas; Dan J Stein Journal: Pediatrics Date: 2016-10-11 Impact factor: 7.124
Authors: Jadrana T F Toich; Paul A Taylor; Martha J Holmes; Suril Gohel; Mark F Cotton; Els Dobbels; Barbara Laughton; Francesca Little; Andre J W van der Kouwe; Bharat Biswal; Ernesta M Meintjes Journal: Front Hum Neurosci Date: 2018-01-11 Impact factor: 3.169