Structural brain alterations can be detected early in HIV infection

Abstract

This cross-sectional brain volumetric study indicates structural alterations early in HIV infection. The findings challenge the prevailing assumption that the brain is spared in this period. Revisiting the question of the brain's vulnerability to processes unfolding in the initial virus-host interaction and the early natural history may yield new insights into neurologic injury in HIV infection and inform neuroprotection strategies.

Regional Cerebral Gray Matter Volume in HIV‐Positive Patients with Executive Function Deficits

“…[9][10][11][12][13] Previous studies also found smaller volumes in several specific anatomical structures, such as the basal ganglia, 9 caudate, 11,13,14 putamen, 14 and total cortex volume of HIV-positive patients. 12 These studies found a correlation between diffuse brain atrophy and motor impairments, 10,14 dementia severity 10 and CDC stages of HIV infection, 11,13 smaller basal ganglia volume and motor dysfunction, 15 caudate and putamen atrophy and longer disease duration. 14 Similarly to these studies, we observed smaller volumes predominantly in the basal ganglia, primarily in the caudate, in HIV-positive patients with cognitive deficits.…”

“…[5][6][7][8] Several authors have previously evaluated brain volume and cortical thickness of HIV-positive patients and have found diffuse brain atrophy and volume reduction in the basal ganglia. [9][10][11][12][13][14][15][16][17][18] However, the majority of previous studies included patients with HIV-associated dementia, 9,10 or did not consider cognitive domains. 15 To the best of our knowledge, no previous study has investigated the cortical thickness and brain volume of HIV-patients with executive functions deficits.…”

Asymptomatic HIV-associated neurocognitive impairment increases risk for symptomatic decline

“…In Table 2 Adjusted relative risk for symptomatic progression: Asymptomatic neurocognitive impairment vs neurocognitively normal addition, neuroimaging studies find detectable structural, functional, and spectroscopic evidence of brain abnormalities even in the acute and early phases of HIV infection. [21][22][23][24][25] Of interest, those with ANI at baseline had evidence of more advanced prior HIV disease, e.g., lower nadir CD4 and greater likelihood of an AIDS diagnosis. This finding supports the concept that ANI is an HIV-driven process that, like more severe forms of HAND, is more likely with greater levels of prior immunosuppression.…”

HIV-1-assoziierte neurokognitive Störung

“…[86]. Raumforderungen und fokale Kontrastmittel(KM)-Anreicherung sind mit der Diagnose HAND nicht vereinbar.…”