It is yet unclear if people infected with human immunodeficiency virus (HIV+) on stable, combined antiretroviral therapies (cARTs) decline with age at the same or greater rate than healthy people. In this study, we examined independent and interactive effects of HIV, age, and HIV-related clinical parameters on neuropsychological functioning and brain regional volume in a sizable group of Polish HIV+ men receiving cART. We also estimated the impact of nadir CD4 cell count, CD4 cell count during participation in the study, duration of HIV infection, or duration of cART along with age. Ninety-one HIV+ and 95 control (HIV−) volunteers ages 23–75 completed a battery of neuropsychological tests, and 54 HIV+ and 62 HIV− of these volunteers participated in a brain imaging assessment. Regional brain volume in the cortical and subcortical regions was measured using voxel-based morphometry. We have found that HIV and older age were independently related to lower attention, working memory, nonverbal fluency, and visuomotor dexterity. Older age but not HIV was associated with less volume in several cortical and subcortical brain regions. In the oldest HIV+ participants, age had a moderating effect on the relationship between the duration of cART and visuomotor performance, such as that older age decreased speed of visuomotor performance along with every year on cART. Such results may reflect the efficacy of cART in preventing HIV-associated brain damage. They also highlight the importance of monitoring neuropsychological functioning and brain structure in HIV+ patients. This is particularly important in older patients with long adherence to cART.Electronic supplementary materialThe online version of this article (10.1007/s13365-018-0679-4) contains supplementary material, which is available to authorized users.

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BackgroundThe primary goal was to examine HIV-related changes in brain activation during a semantic memory task. The secondary goal was to assess whether the functional connectivity of the brain regions showing altered activity during the semantic memory task is related to HIV serostatus.Participants and procedureThe total group of 17 male subjects, aged on average 44 years, included 8 HIV+/cART+ and 9 demographically matched healthy comparators. Participants completed Famous Names Recognition task-functional magnetic resonance imaging (fMRI) and resting state fMRI.ResultsWe found an effect of HIV status on brain activation during the semantic memory task, despite comparable accuracy and reaction time across groups. Compared to healthy individuals, in HIV+ participants recognition of famous names elicited less activity in the fronto-striatal network, particularly in the left caudate nucleus (p = .049), left inferior frontal gyrus (p = .047), left thalamus (p = .031) and right thalamus (p = .047), as well as in the left middle occipital gyrus (p = .028). Although an effect of HIV status on functional connectivity of the brain regions showing altered activity during semantic memory task was not observed, resting-state activation of those regions was significantly correlated with performance on cognitive domains of attention, executive functioning, psychomotor speed and semantic skills.ConclusionsOur findings suggest the presence of functional brain network reorganization in HIV+/cART+ patients, particu-larly in subcortical regions of the fronto-striatal network, in the absence of neurocognitive decline.

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