No evidence for accelerated ageing-related brain pathology in treated HIV: longitudinal neuroimaging results from the Comorbidity in Relation to AIDS (COBRA) project

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Title: No evidence for accelerated ageing-related brain pathology in treated HIV: longitudinal neuroimaging results from the Comorbidity in Relation to AIDS (COBRA) project
Authors: Cole, JH
Caan, M
Underwood, J
De Francesco, D
Van Zoest, R
Wit, F
Mutsaerts, H
Leech, R
Geurtsen, G
Portigies, P
Majoie, C
Schim van der Loeff, M
Sabin, C
Reiss, P
Winston, A
Sharp, D
Item Type: Journal Article
Abstract: Background Despite successful antiretroviral therapy people living with HIV (PLWH) experience higher rates of age-related morbidity, including abnormal brain structure, brain function and cognitive impairment. This has raised concerns that PLWH may experience accelerated ageing-related brain pathology. Methods We performed a multi-centre longitudinal study of 134 virologically-suppressed PLWH (median age = 56.0 years) and 79 demographically-similar HIV-negative controls (median age = 57.2 years). To measure cognitive performance and brain pathology, we conducted detailed neuropsychological assessments and multi-modality neuroimaging (T1-weighted, T2-weighted, diffusion-MRI, resting-state functional-MRI, spectroscopy, arterial spin labelling) at baseline and after two-year follow-up. Group differences in rates of change were assessed using linear mixed effects models. Results 123 PLWH and 78 HIV-negative controls completed longitudinal assessments (median interval = 1.97 years). There were no differences between PLWH and HIV-negative controls in age, sex, years of education, smoking, alcohol use, recreational drug use, blood pressure, body-mass index or cholesterol levels. At baseline, PLWH had poorer global cognitive performance (P<0.01), lower grey matter volume (P=0.04), higher white matter hyperintensity load (P=0.02), abnormal white-matter microstructure (P<0.005) and greater ‘brain-predicted age difference’ (P=0.01). Longitudinally, there were no significant differences in rates of change in any neuroimaging measure between PLWH and HIV-negative controls (P>0.1). Cognitive performance was stable across the study period in both groups. Conclusions Our finding indicate that when receiving successful treatment, middle-aged PLWH are not at increased risk of accelerated ageing-related brain changes or cognitive decline over two years, when compared to closely-matched HIV-negative controls.
Issue Date: 1-Jun-2018
Date of Acceptance: 13-Dec-2017
URI: http://hdl.handle.net/10044/1/55593
DOI: https://dx.doi.org/10.1093/cid/cix1124
ISSN: 1058-4838
Publisher: Oxford University Press (OUP)
Start Page: 1899
End Page: 1909
Journal / Book Title: Clinical Infectious Diseases
Volume: 66
Issue: 12
Copyright Statement: © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. This is a pre-copyedited, author-produced PDF of an article accepted for publication in Clinical Infectious Diseases following peer review. The version of record James H Cole, Matthan WA Caan, Jonathan Underwood, Davide De Francesco, Rosan A van Zoest, Ferdinand WNM Wit, Henk JMM Mutsaerts, Rob Leech, Gert J Geurtsen, Peter Portegies, Charles BLM Majoie, Maarten F Schim van der Loeff, Caroline A Sabin, Peter Reiss, Alan Winston, David J Sharp, ; No evidence for accelerated ageing-related brain pathology in treated HIV: longitudinal neuroimaging results from the Comorbidity in Relation to AIDS (COBRA) project, Clinical Infectious Diseases, is available online at: https://dx.doi.org/10.1093/cid/cix1124
Sponsor/Funder: Commission of the European Communities
National Institute for Health Research
Funder's Grant Number: 305522
NIHR-RP-011-048
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
HIV
aging
neuroimaging
brain structure
cognitive function
COMBINATION ANTIRETROVIRAL THERAPY
CEREBRAL-BLOOD-FLOW
HIV-INFECTION
RISK-FACTORS
MEN
DISEASE
ATROPHY
INJURY
AGE
NEURODEGENERATION
COBRA collaboration
06 Biological Sciences
11 Medical And Health Sciences
Microbiology
Publication Status: Published
Online Publication Date: 2018-01-04
Appears in Collections:Department of Medicine
Faculty of Medicine



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