Cerebral injury in perinatally HIV-infected children compared to matched healthy controls

被引:59
作者
Cohen, Sophie [1 ]
Caan, Matthan W. A. [2 ]
Mutsaerts, Henk-Jan [2 ]
Scherpbier, Henriette J. [1 ]
Kuijpers, Taco W. [1 ]
Reiss, Peter [3 ,4 ,5 ,6 ]
Majoie, Charles B. L. M. [2 ]
Pajkrt, Dasja [1 ]
机构
[1] Emma Childrens Hosp AMC, Dept Pediat Hematol Immunol & Infect Dis, Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Radiol, NL-1105 AZ Amsterdam, Netherlands
[3] Univ Amsterdam, Acad Med Ctr, Dept Global Hlth, NL-1105 AZ Amsterdam, Netherlands
[4] Univ Amsterdam, Acad Med Ctr, Amsterdam Inst Global Hlth & Dev, NL-1105 AZ Amsterdam, Netherlands
[5] Univ Amsterdam, Acad Med Ctr, Dept Internal Med, Div Infect Dis,Ctr Infect & Immun Amsterdam CINIM, NL-1105 AZ Amsterdam, Netherlands
[6] HIV Monitoring Fdn, Amsterdam, Netherlands
关键词
WHITE-MATTER HYPERINTENSITIES; HUMAN-IMMUNODEFICIENCY-VIRUS; ANTIRETROVIRAL THERAPY; COGNITIVE IMPAIRMENT; MULTIPLE-SCLEROSIS; POSITIVE CHILDREN; DIFFUSION; BRAIN; MRI; NEUROPATHOGENESIS;
D O I
10.1212/WNL.0000000000002209
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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.
引用
收藏
页码:19 / 27
页数:9
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