Cerebral injury in perinatally HIV-infected children compared to matched healthy controls.
Cohen, Sophie MD; Caan, Matthan W.A. PhD; Mutsaerts, Henk-Jan MD; Scherpbier, Henriette J. MD, PhD; Kuijpers, Taco W. MD, PhD; Reiss, Peter MD, PhD; Majoie, Charles B.L.M. MD, PhD; Pajkrt, Dasja MD, PhD
86(1):19-27, January 5, 2016.
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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.
(C) 2016 American Academy of Neurology