Cerebral alterations in West African HIV and non-HIV adults aged ≥50: An MRI study

Bernard, Charlotte; Dilharreguy, Bixente; Font, Hélène; Diop, Aliou; Tine, Judicaël; Diakhaté, I.C.; Seydi, Moussa; Dartigues, Jean‐François; Dabis, François; Catheline, Gwénaëlle; Bonnet, Fabrice

doi:10.1016/j.ijid.2020.12.016

Cited by 7 publications

(8 citation statements)

References 41 publications

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“…40,41 More specific to HIV, a previous study with PLWH on ART found that women were less likely to present with global atrophy. 38 We have previously reported that HIV seropositivity is associated with brain WMHs, analyzed qualitatively through manual scoring by expert neurologists from this cohort, and may be mediated by cardiovascular comorbidities. 11 Out of the 376 total scans herein, there were 155 overlapping MRI scans, and the results showed a strong correlation between C-DEF's quantitative measurement of WMH volume and Fazekas score.…”

Section: Discussionmentioning

confidence: 92%

“…Most studies have found no significant difference or no rapid worsening of WMH in PLWH after 2 years of follow-up, possibly highlighting the heterogeneity and comorbidities affecting WMH in any cohort of PLWH. 9,13,14,28,38 Indeed, the difference in WMH for black and white participants approached significance, with black participants having a 50% faster increase in WMHs over time. These race disparities should be explored more in the future, especially given that HIV and cardiovascular risk factors affect the black community disproportionately.…”

Section: Discussionmentioning

confidence: 93%

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White and Gray Matter Changes are Associated With Neurocognitive Decline in HIV Infection

Chien,

Wu,

Lau

et al. 2024

Annals of Neurology

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ObjectiveTo investigate the relationship between neurocognitive deficits and structural changes on brain magnetic resonance imaging in people living with HIV (PLWH) with good virological control on combination antiretroviral therapy, compared with socioeconomically matched control participants recruited from the same communities.MethodsBrain magnetic resonance imaging scans, and clinical and neuropsychological data were obtained from virologically controlled PLWH (viral load of <50 c/mL and at least 1 year of combination antiretroviral therapy) and socioeconomically matched control participants. Magnetic resonance imaging was carried out on 3 T scanner with 8‐channel head coils and segmented using Classification using Derivative‐based Features. Multiple regression analysis was performed to examine the association between brain volume and various clinical and neuropsychiatric parameters adjusting for age, race, and sex. To evaluate longitudinal changes in brain volumes, a random coefficient model was used to evaluate the changes over time (age) adjusting for sex and race.ResultsThe cross‐sectional study included 164 PLWH and 51 controls, and the longitudinal study included 68 PLWH and 20 controls with 2 or more visits (mean 2.2 years, range 0.8–5.1 years). Gray matter (GM) atrophy rate was significantly higher in PLWH compared with control participants, and importantly, the GM and global atrophy was associated with the various neuropsychological domain scores. Higher volume of white matter hyperintensities were associated with increased atherosclerotic cardiovascular disease risk score, and decreased executive functioning and memory domain scores in PLWH.InterpretationThese findings suggest ongoing neurological damage even in virologically controlled participants, with significant implications for clinical management of PLWH. ANN NEUROL 2024

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 93%

White and Gray Matter Changes are Associated With Neurocognitive Decline in HIV Infection

Chien,

Wu,

Lau

et al. 2024

Annals of Neurology

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“…In SSA, to our knowledge, few data are available on the relationship between cardiovascular risk and cognition. One recent study in Senegal reported an association between hypertension and brain atrophy among PLHIV aged 50 years old or above [ 68 ] but due to limited sample size, the authors could not go further in the analyses and no cognitive evaluation was included. As cardiovascular diseases/risks factors and aging are associated with neuronal injury and inflammation in PLHIV stable on ART, some researchers suggest a tripartite model of HIV infection, aging, and cardiovascular disease/risk factors to explain neurocognitive impairment in PLHIV [ 69 ].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with verbal fluency in older adults living with HIV in West Africa: A longitudinal study

Bernard

Font

Diallo

et al. 2022

Tropical Med Int Health

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Objective: Verbal fluency decline, observed both in aging and HIV infection, has been related to lower quality of life. This study aimed to evaluate the factors associated with categorical fluency in people living with HIV (PLHIV) aged ≥60 years living in West Africa. Methods: In this longitudinal study, PLHIV aged ≥60 years, on antiretroviral therapy (ART) for ≥6 months were included in three clinics (two in Côte d'Ivoire, one in Senegal) participating in the West Africa International epidemiological Databases to Evaluate AIDS (IeDEA) collaboration. Categorical fluency was evaluated with the Isaacs Set Test at 60 s at baseline and 2 years later. Factors associated with verbal fluency baseline performance and annual rates of changes were evaluated using multivariate linear regression models. Results: Ninety-seven PLHIV were included with 41 of them (42%) having a 2-year follow-up visit. The median age was 64 (62-67), 45.4% were female, and 89.7% had an undetectable viral load. The median annual change in categorical fluency scores was À0.9 (IQR: À2.7 to 1.8). Low baseline categorical fluency performance and its decline were associated with older age and being a female. Low educational level was associated with low baseline categorical fluency performance but not with its decline. Categorical fluency decline was also associated with marital status and hypertension. Conclusions: Among older West African PLHIV, usual socio-demographic variables and hypertension were the main factors associated with low categorical fluency performance and/or its decline. Interventions that focus on supporting cardiometabolic health are highly recommended to prevent cognitive disorders in PLHIV.

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“…20 Beyond NCDs, MRI can play a paramount role in the management of infectious diseases, such as HIV and malaria. [21][22][23] Furthermore, in the context of a growing global cancer burden, access to imaging services can avert millions of cancer deaths annually worldwide. 3 MRI is a core component of cancer management in high-income countries as it enables early and accurate diagnosis of cancer, thereby facilitating the treatment of neoplasms at a stage when they are more likely to be treatable.…”

Section: Introductionmentioning

confidence: 99%

“…The cerebrovascular implications of systemic disorders such as sickle cell disease with a high prevalence rate in SSA make neuroimaging particularly important in the region 20 . Beyond NCDs, MRI can play a paramount role in the management of infectious diseases, such as HIV and malaria 21–23 …”

Section: Introductionmentioning

confidence: 99%

A framework for advancing sustainable magnetic resonance imaging access in Africa

Anazodo

Ehiogu

et al. 2022

NMR in Biomedicine

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Magnetic resonance imaging (MRI) technology has profoundly transformed current healthcare systems globally, owing to advances in hardware and software research innovations. Despite these advances, MRI remains largely inaccessible to clinicians, patients, and researchers in low‐resource areas, such as Africa. The rapidly growing burden of noncommunicable diseases in Africa underscores the importance of improving access to MRI equipment as well as training and research opportunities on the continent. The Consortium for Advancement of MRI Education and Research in Africa (CAMERA) is a network of African biomedical imaging experts and global partners, implementing novel strategies to advance MRI access and research in Africa. Upon its inception in 2019, CAMERA sets out to identify challenges to MRI usage and provide a framework for addressing MRI needs in the region. To this end, CAMERA conducted a needs assessment survey (NAS) and a series of symposia at international MRI society meetings over a 2‐year period. The 68‐question NAS was distributed to MRI users in Africa and was completed by 157 clinicians and scientists from across Sub‐Saharan Africa (SSA). On average, the number of MRI scanners per million people remained at less than one, of which 39% were obsolete low‐field systems but still in use to meet daily clinical needs. The feasibility of coupling stable energy supplies from various sources has contributed to the growing number of higher‐field (1.5 T) MRI scanners in the region. However, these systems are underutilized, with only 8% of facilities reporting clinical scans of 15 or more patients per day, per scanner. The most frequently reported MRI scans were neurological and musculoskeletal. The CAMERA NAS combined with the World Health Organization and International Atomic Energy Agency data provides the most up‐to‐date data on MRI density in Africa and offers a unique insight into Africa's MRI needs. Reported gaps in training, maintenance, and research capacity indicate ongoing challenges in providing sustainable high‐value MRI access in SSA. Findings from the NAS and focused discussions at international MRI society meetings provided the basis for the framework presented here for advancing MRI capacity in SSA. While these findings pertain to SSA, the framework provides a model for advancing imaging needs in other low‐resource settings.

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Cerebral alterations in West African HIV and non-HIV adults aged ≥50: An MRI study

Cited by 7 publications

References 41 publications

White and Gray Matter Changes are Associated With Neurocognitive Decline in HIV Infection

White and Gray Matter Changes are Associated With Neurocognitive Decline in HIV Infection

Factors associated with verbal fluency in older adults living with HIV in West Africa: A longitudinal study

A framework for advancing sustainable magnetic resonance imaging access in Africa

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