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Bravo CA, Moon JY, Davy K, Kaplan RC, Anastos K, Rodriguez CJ, Post WS, Gange SJ, Kassaye SG, Kingsley LA, Lazar JM, Mack WJ, Pyslar N, Tien PC, Witt MD, Palella FJ, Li Y, Yan M, Hodis HN, Hanna DB. Association of HIV and HCV Infection With Carotid Artery Plaque Echomorphology in the MACS/WIHS Combined Cohort Study. Stroke 2024; 55:651-659. [PMID: 38333992 PMCID: PMC10940210 DOI: 10.1161/strokeaha.123.043922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND HIV and hepatitis C virus (HCV) are associated with increased risk of carotid artery atherosclerotic plaque and stroke. We examined associations of HIV- and HCV-related factors with echomorphologic features of carotid artery plaque. METHODS This cross-sectional study included participants from the MACS (Multicenter AIDS Cohort Study)/WIHS (Women's Interagency HIV Study) Combined Cohort Study who underwent high-resolution B-mode carotid artery ultrasound. Plaques were characterized from 6 areas of the right carotid artery. Poisson regression controlling for demographic and cardiometabolic risk factors determined adjusted prevalence ratios (aPRs) and 95% CIs for associations of HIV- and HCV-related factors with echomorphologic features. RESULTS Of 2655 participants (65% women, median age 44 [interquartile range, 37-50] years), 1845 (70%) were living with HIV, 600 (23%) were living with HCV, and 425 (16%) had carotid plaque. There were 191 plaques identified in 129 (11%) women with HIV, 51 plaques in 32 (7%) women without HIV, 248 plaques in 171 (28%) men with HIV, and 139 plaques in 93 (29%) men without HIV. Adjusted analyses showed that people with HIV and current CD4+ count <200 cells/µL had a significantly higher prevalence of predominantly echolucent plaque (aPR, 1.86 [95% CI, 1.08-3.21]) than those without HIV. HCV infection alone (aPR, 1.86 [95% CI, 1.08-3.19]) and HIV-HCV coinfection (aPR, 1.75 [95% CI, 1.10-2.78]) were each associated with higher prevalence of predominantly echogenic plaque. HIV-HCV coinfection was also associated with higher prevalence of smooth surface plaque (aPR, 2.75 [95% CI, 1.03-7.32]) compared with people without HIV and HCV. CONCLUSIONS HIV with poor immunologic control, as well as HCV infection, either alone or in the presence of HIV, were associated with different echomorphologic phenotypes of carotid artery plaque.
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Affiliation(s)
| | | | | | - Robert C. Kaplan
- Albert Einstein College of Medicine, Bronx, NY, USA
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | | | | | - Wendy S. Post
- Johns Hopkins University, School of Medicine, Baltimore, MD, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stephen J. Gange
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Jason M. Lazar
- State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Wendy J. Mack
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Phyllis C. Tien
- University of California-San Francisco and Department of Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Mallory D. Witt
- Lundquist Institute for Biomedical Research at Harbor-UCLA Medical Center, Los Angeles, CA, USA
| | - Frank J. Palella
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Yanjie Li
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mingzhu Yan
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Howard N. Hodis
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Buthelezi TE, Venkatakrishna SSB, Lucas S, Workman L, Dheda K, Nicol MP, Zar HJ, Andronikou S. A comparison of chest radiographic findings in human immunodeficiency virus-positive and -negative children with pulmonary tuberculosis. Clin Radiol 2024; 79:e317-e324. [PMID: 38065775 DOI: 10.1016/j.crad.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 01/02/2024]
Abstract
AIM To compare chest radiography (CXR) findings in human immunodeficiency virus (HIV)-positive and HIV-negative children who had microbiologically confirmed pulmonary tuberculosis (PTB). MATERIALS AND METHODS Retrospective analysis of CXRs from children with known HIV status and microbiologically confirmed PTB (culture or GeneXpert Xpert MTB/RIF positive), who were hospitalised or seen at a primary healthcare centre over a 5-year period. Radiological findings were compared according to HIV and nutritional status. RESULTS CXRs of 130 children were analysed from 35 (27%) HIV- positive and 95 (73%) HIV-negative children with confirmed PTB, median age 45.7 months (interquartile range [IQR] 18-81.3 months). CXR changes consistent with PTB were reported in 21/35 (60%) of HIV-positive and 59/95 (62%) of HIV-negative patients, (p=0.81). Normal CXR was identified in 3/35 (8.6%) of HIV-positive and 5/95 (5.3%) of HIV-negative patients (p=0.81). Airway compression was present in 3/35 (8.6%) of HIV-positive and 7/95 (7.4%) of HIV-negative patients (p>0.99). Overall, lymphadenopathy was identified in 42/130 (32.3%) of patients, 11/35 (31.4 %) were HIV-positive compared with 31/95 (32.6%) HIV-negative patients. Airspace consolidation was present in 60% of both HIV-positive (21/35) and HIV-negative patients (57/95). Pleural effusion was present in 2/35 (5.7 %) of HIV-negative and 9/95 (9.5 %) of HIV-negative patients. There were no statistically significant radiological differences by HIV group. CONCLUSION There were no significant differences in the CXR findings between the HIV-positive and HIV-negative children with confirmed PTB.
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Affiliation(s)
- T E Buthelezi
- Department of Diagnostic Radiology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, South Africa
| | - S S B Venkatakrishna
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - S Lucas
- Department of Diagnostic Radiology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, South Africa
| | - L Workman
- Department of Paediatrics & Child Health, Red Cross Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - K Dheda
- Lung Infection and Immunity Unit, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - M P Nicol
- Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Australia; Division of Medical Microbiology, University of Cape Town and National Health Laboratory Services, South Africa
| | - H J Zar
- Department of Paediatrics & Child Health, Red Cross Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - S Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Fousse M, Heit M, Fassbender K, Kaddu-Mulindwa D. PLWH treated with modern ART and high CD4 T cell counts: no evidence of HIV-associated vasculopathy measured by extra- and intracranial ultrasound. Acta Neurol Belg 2024; 124:363-365. [PMID: 37490199 PMCID: PMC10874338 DOI: 10.1007/s13760-023-02339-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Mathias Fousse
- Department of Neurology, Saarland University Medical School, Kirrberger Str. 100, 66421, Homburg, Germany.
| | - Matthias Heit
- Department of Hematology and Oncology, Clinical Immunology, Rheumatology, Saarland University Medical School, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Klaus Fassbender
- Department of Neurology, Saarland University Medical School, Kirrberger Str. 100, 66421, Homburg, Germany
| | - Dominic Kaddu-Mulindwa
- Department of Hematology and Oncology, Clinical Immunology, Rheumatology, Saarland University Medical School, Kirrberger Str. 100, 66421, Homburg, Germany
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Qi Y, Wang W, Rao B, Yang X, Yu W, Li JY, Sun ZC, Zhou F, Li YZ, Guo YF, Wang Y, Li HJ. Value of Radiomic Analysis Combined With Diffusion Tensor Imaging in Early Diagnosis of HIV-Associated Neurocognitive Disorders. J Magn Reson Imaging 2023; 58:1882-1891. [PMID: 37118972 DOI: 10.1002/jmri.28741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND The combination of radiomics and diffusion tensor imaging (DTI) may have potential clinical value in the early stage of HIV-associated neurocognitive disorders (HAND). PURPOSE To investigate the value of DTI-based radiomics in the early stage of HAND in people living with HIV (PLWH). STUDY TYPE Retrospective. POPULATION A total of 138 male PLWH were included, including 68 with intact cognition (IC) and 70 with asymptomatic neurocognitive impairment (ANI). Seventy healthy controls (HCs) were recruited for tract-based spatial statistics (TBSS) analysis. All PLWHs were randomly divided into training and validation cohorts at a 7:3 ratio. FIELD STRENGTH/SEQUENCE A 3 T, single-shot spin-echo echo planar imaging (EPI). ASSESSMENT The differences between the PLWH groups were compared using TBSS and region of interest (ROI) analysis. Radiomic features were extracted from the corpus callosum (CC) on DTI postprocessed images, including fractional anisotropy (FA), axial diffusivity (AD), mean diffusivity (MD), and radial diffusivity (RD). The performance of the radiomic signatures was evaluated by ROC curve analysis. The radiomic signature with the highest area under the curve (AUC) was combined with clinical characteristics to construct a nomogram. Decision curve analysis (DCA) was performed to evaluate the ability of different methods in discriminating ANI. STATISTICAL TESTS Chi-square test, independent-samples t test, Kruskal-Wallis test, Mann-Whitney U test, threshold-free cluster enhancement (TFCE), ROC curve analysis, DCA, multivariate logistic regression analysis, Hosmer-Lemeshow test. P < 0.05 with TFCE corrected and P < 0.0001 without TFCE corrected were considered statistically significant. RESULTS The ANI group showed lower FA and higher AD than the IC group. In the validation cohort, the AUCs of the FA-, AD-, MD- and RD-based radiomic signatures and the clinicoradiomic nomogram were 0.829, 0.779, 0.790, 0.864, and 0.874, respectively. DCA revealed that the nomogram was of greater clinical value than TBSS analysis, the clinical models, and the RD-based radiomic signature. DATA CONCLUSION The combination of DTI and radiomics is correlated with early stage of HAND in PLWH. EVIDENCE LEVEL 3. TECHNICAL EFFICACY Stage 2.
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Affiliation(s)
- Yu Qi
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Wei Wang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Bo Rao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xue Yang
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wen Yu
- Center for Rehabilitation Medicine, Department of Psychiatry, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, China
| | - Jia-Ying Li
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhi-Chao Sun
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Feini Zhou
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuan-Zhe Li
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Yi-Fan Guo
- Department of Radiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yi Wang
- Department of CT/MRI, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Hong-Jun Li
- Department of Radiology, Beijing Youan Hospital, Capital Medical University, Beijing, China
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Babiloni C, Del Percio C, Piervincenzi C, Carducci F, Ferri R, Onorati P, Toma G, Ferracuti S, Roma P, Correr V, Di Campli F, Aceti A, Salvatore M, Soricelli A, Teti E, Pennica A, Sarmati L, Vullo V, D'Ettorre G, Mastroianni C, Petsas N, Pantano P, Floris R, Stocchi F, Andreoni M, Di Perri G, Calcagno A, Noce G. Parietal resting-state EEG alpha source connectivity is associated with subcortical white matter lesions in HIV-positive people. Clin Neurophysiol 2023; 156:19-27. [PMID: 37844524 DOI: 10.1016/j.clinph.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 08/07/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVE Parietal resting-state electroencephalographic (rsEEG) alpha (8-10 Hz) source connectivity is abnormal in HIV-positive persons. Here we tested whether this abnormality may be associated with subcortical white matter vascular lesions in the cerebral hemispheres. METHODS Clinical, rsEEG, and magnetic resonance imaging (MRI) datasets in 38 HIV-positive persons and clinical and rsEEG datasets in 13 healthy controls were analyzed. Radiologists visually evaluated the subcortical white matter hyperintensities from T2-weighted FLAIR MRIs (i.e., Fazekas scale). In parallel, neurophysiologists estimated the eLORETA rsEEG source lagged linear connectivity from parietal cortical regions of interest. RESULTS Compared to the HIV participants with no/negligible subcortical white matter hyperintensities, the HIV participants with mild/moderate subcortical white matter hyperintensities showed lower parietal interhemispheric rsEEG alpha lagged linear connectivity. This effect was also observed in HIV-positive persons with unimpaired cognition. This rsEEG marker allowed good discrimination (area under the receiver operating characteristic curve > 0.80) between the HIV-positive individuals with different amounts of subcortical white matter hyperintensities. CONCLUSIONS The parietal rsEEG alpha source connectivity is associated with subcortical white matter vascular lesions in HIV-positive persons, even without neurocognitive disorders. SIGNIFICANCE Those MRI-rsEEG markers may be used to screen HIV-positive persons at risk of neurocognitive disorders.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, (FR), Italy.
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Filippo Carducci
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Paolo Onorati
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Ginevra Toma
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Paolo Roma
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Valentina Correr
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Francesco Di Campli
- Infectious Diseases, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonio Aceti
- Infectious Diseases, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Andrea Soricelli
- IRCCS Synlab SDN, Naples, Italy; Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Alfredo Pennica
- Infectious Diseases, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Vincenzo Vullo
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Gabriella D'Ettorre
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Claudio Mastroianni
- Department of Public Health and Infectious Diseases, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | | | - Patrizia Pantano
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; IRCCS NEUROMED, Pozzilli, IS, Italy
| | - Roberto Floris
- Diagnostic and Interventional Radiology, University of Rome "Tor Vergata", Rome, Italy
| | - Fabrizio Stocchi
- IRCCS San Raffaele, Rome, Italy; Telematic University San Raffaele, Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Giovanni Di Perri
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Andrea Calcagno
- Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Turin, Italy
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Minosse S, Picchi E, Conti A, di Giuliano F, di Ciò F, Sarmati L, Teti E, de Santis S, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Multishell diffusion MRI reveals whole-brain white matter changes in HIV. Hum Brain Mapp 2023; 44:5113-5124. [PMID: 37647214 PMCID: PMC10502617 DOI: 10.1002/hbm.26448] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 07/15/2023] [Accepted: 07/26/2023] [Indexed: 09/01/2023] Open
Abstract
Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) have been previously used to explore white matter related to human immunodeficiency virus (HIV) infection. While DTI and DKI suffer from low specificity, the Combined Hindered and Restricted Model of Diffusion (CHARMED) provides additional microstructural specificity. We used these three models to evaluate microstructural differences between 35 HIV-positive patients without neurological impairment and 20 healthy controls who underwent diffusion-weighted imaging using three b-values. While significant group effects were found in all diffusion metrics, CHARMED and DKI analyses uncovered wider involvement (80% vs. 20%) of all white matter tracts in HIV infection compared with DTI. In restricted fraction (FR) analysis, we found significant differences in the left corticospinal tract, middle cerebellar peduncle, right inferior cerebellar peduncle, right corticospinal tract, splenium of the corpus callosum, left superior cerebellar peduncle, left superior cerebellar peduncle, pontine crossing tract, left posterior limb of the internal capsule, and left/right medial lemniscus. These are involved in language, motor, equilibrium, behavior, and proprioception, supporting the functional integration that is frequently impaired in HIV-positivity. Additionally, we employed a machine learning algorithm (XGBoost) to discriminate HIV-positive patients from healthy controls using DTI and CHARMED metrics on an ROIwise basis, and unique contributions to this discrimination were examined using Shapley Explanation values. The CHARMED and DKI estimates produced the best performance. Our results suggest that biophysical multishell imaging, combining additional sensitivity and built-in specificity, provides further information about the brain microstructural changes in multimodal areas involved in attentive, emotional and memory networks often impaired in HIV patients.
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Affiliation(s)
- Silvia Minosse
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
| | - Eliseo Picchi
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Allegra Conti
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesca di Giuliano
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Francesco di Ciò
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Loredana Sarmati
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Elisabetta Teti
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
| | - Silvia de Santis
- Instituto de NeurocienciasConsejo Superior de Investigaciones Científicas and Universidad Miguel HernándezSant Joan d'AlacantSpain
| | - Massimo Andreoni
- Clinical Infectious Diseases UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Department of Systems MedicineUniversity of Rome Tor VergataRomeItaly
| | - Roberto Floris
- Diagnostic Imaging UnitUniversity Hospital Rome Tor VergataRomeItaly
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Maria Guerrisi
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Francesco Garaci
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- IRCSS San Raffaele CassinoFrosinoneItaly
| | - Nicola Toschi
- Neuroradiology UnitUniversity Hospital of Rome Tor VergataRomeItaly
- Athinoula A. Martinos Center for Biomedical ImagingHarvard Medical SchoolBostonMassachusettsUSA
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7
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Xu M, Ju XD. A meta-analysis of gray matter volume abnormalities in HIV patients. Psychiatry Res Neuroimaging 2023; 335:111722. [PMID: 37862957 DOI: 10.1016/j.pscychresns.2023.111722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/31/2023] [Accepted: 10/02/2023] [Indexed: 10/22/2023]
Abstract
HIV infection is known to have significant effects on central nervous system. This study conducted a meta-analysis of whole voxel-based morphometry (VBM) in HIV patients (N = 435) and HIV-uninfected controls (N = 397). This study observed a reduction of limbic lobe, cingulate gyrus, frontal lobe, middle frontal gyrus, sub-lobar, insula, inferior frontal gyrus and superior frontal gyrus volume in HIV patients. These morphological differences may be responsible for cognitive decline in HIV patients, as these brain regions are closely related to motor and memory functions. These results contribute to a better understanding of the neural mechanisms underlying brain injury in HIV patients and could help develop targeted brain targets, provide more personalized treatment and predict neurodevelopmental outcomes.
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Affiliation(s)
- Mingxiang Xu
- School of Psychology, Northeast Normal University, No. 5268 Renmin Street, Changchun 130024, China
| | - Xing-Da Ju
- School of Psychology, Northeast Normal University, No. 5268 Renmin Street, Changchun 130024, China; Jilin Provincial Key Laboratory of Cognitive Neuroscience and Brain Development, Changchun,Jilin 130024, China.
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8
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Torgersen J, Akers S, Huo Y, Terry JG, Carr JJ, Ruutiainen AT, Skanderson M, Levin W, Lim JK, Taddei TH, So-Armah K, Bhattacharya D, Rentsch CT, Shen L, Carr R, Shinohara RT, McClain M, Freiberg M, Justice AC, Re VL. Performance of an automated deep learning algorithm to identify hepatic steatosis within noncontrast computed tomography scans among people with and without HIV. Pharmacoepidemiol Drug Saf 2023; 32:1121-1130. [PMID: 37276449 PMCID: PMC10527049 DOI: 10.1002/pds.5648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/06/2023] [Accepted: 05/31/2023] [Indexed: 06/07/2023]
Abstract
PURPOSE Hepatic steatosis (fatty liver disease) affects 25% of the world's population, particularly people with HIV (PWH). Pharmacoepidemiologic studies to identify medications associated with steatosis have not been conducted because methods to evaluate liver fat within digitized images have not been developed. We determined the accuracy of a deep learning algorithm (automatic liver attenuation region-of-interest-based measurement [ALARM]) to identify steatosis within clinically obtained noncontrast abdominal CT images compared to manual radiologist review and evaluated its performance by HIV status. METHODS We performed a cross-sectional study to evaluate the performance of ALARM within noncontrast abdominal CT images from a sample of patients with and without HIV in the US Veterans Health Administration. We evaluated the ability of ALARM to identify moderate-to-severe hepatic steatosis, defined by mean absolute liver attenuation <40 Hounsfield units (HU), compared to manual radiologist assessment. RESULTS Among 120 patients (51 PWH) who underwent noncontrast abdominal CT, moderate-to-severe hepatic steatosis was identified in 15 (12.5%) persons via ALARM and 12 (10%) by radiologist assessment. Percent agreement between ALARM and radiologist assessment of absolute liver attenuation <40 HU was 95.8%. Sensitivity, specificity, positive predictive value, and negative predictive value of ALARM were 91.7% (95%CI, 51.5%-99.8%), 96.3% (95%CI, 90.8%-99.0%), 73.3% (95%CI, 44.9%-92.2%), and 99.0% (95%CI, 94.8%-100%), respectively. No differences in performance were observed by HIV status. CONCLUSIONS ALARM demonstrated excellent accuracy for moderate-to-severe hepatic steatosis regardless of HIV status. Application of ALARM to radiographic repositories could facilitate real-world studies to evaluate medications associated with steatosis and assess differences by HIV status.
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Affiliation(s)
- Jessie Torgersen
- Department of Medicine, Penn Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Scott Akers
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - Yuankai Huo
- Department of Computer Science, Vanderbilt University, Nashville, TN, USA
| | - James G. Terry
- Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - J. Jeffrey Carr
- Department of Radiology and Radiological Sciences, Vanderbilt University School of Medicine, Nashville, TN, USA
| | | | - Melissa Skanderson
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Woody Levin
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joseph K. Lim
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Tamar H. Taddei
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
| | - Kaku So-Armah
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Debika Bhattacharya
- VA Greater Los Angeles Healthcare System and David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Christopher T. Rentsch
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Li Shen
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Rotonya Carr
- Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, WA, USA
| | - Russell T. Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Biomedical Image Computing and Analysis (CBICA), Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104
- Penn Statistics in Imaging and Visualization Endeavor (PennSIVE), Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, 19104
| | | | - Matthew Freiberg
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Amy C. Justice
- Department of Medicine, Yale School of Medicine, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, CT, USA
- Division of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Vincent Lo Re
- Department of Medicine, Penn Center for AIDS Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology, and Informatics, Center for Clinical Epidemiology and Biostatistics, Center for Real World Effectiveness and Safety of Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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9
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Chaganti J, Gates TM, Brew BJ. Reversible large-scale network disruption correlates with neurocognitive improvement in HIV-associated minor neurocognitive disorder with combined anti-retroviral therapy intensification: a prospective longitudinal resting-state functional magnetic resonance imaging study. Neurol Sci 2023; 44:3261-3269. [PMID: 37052787 DOI: 10.1007/s10072-023-06783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/23/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE HIV-associated neurocognitive disorder (HAND) affects multiple cognitive domains and currently, the neuropsychological testing is the gold standard to identify these deficits. The aim of this longitudinal 12-month pilot study is to determine the effect of intensified combination antiretroviral therapy (cART) on rs-fMRI in virally suppressed (both in CSF and blood) patients with active HAND (those who have progressive neurocognitive impairment) and correlated with neurocognitive function tests. METHODS In this pilot study, we have evaluated sixteen patients with active HAND with viral suppression in both blood and CSF to study the effect of cART on functional connectivity. Participants underwent rs-fMRI at the baseline (time point-1 (TP-1) and 12-month visits (time point-2 (TP-2)). Connectivity in the five major networks was measured at TP-1 and TP-2 using the seed-based approach. All the participants underwent a five-domain neuropsychological battery at TP-1 and TP-2. Neurocognitive scores (NC) as well as blood and CSF markers were correlated with functional connectivity (FC). RESULTS There was a significant increase in the FC between the two time points within the executive, salience, default mode, dorsal attention, and visual networks at voxel level threshold of p < 0.001 and cluster level threshold of p < 0.05 and corrected for false detection rate (FDR). The neurocognitive scores were positively correlated with all the networks at similar cluster and voxel level thresholds. CONCLUSIONS These results indicate that rs-fMRI can be potentially used as one of the biomarkers for treatment efficacy in HAND.
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Affiliation(s)
- Joga Chaganti
- Department of Medical Imaging, St Vincent's Hospital, Sydney, Australia.
| | - Thomas M Gates
- Center for Applied Medical Research Program, St Vincent's Hospital, Sydney, Australia
| | - Bruce J Brew
- Department of Neurology, Head Neuroscience Program and Peter Duncan Neuroscience Centre for Applied Medical Research, St Vincent's Hospital, University of New South Wales, Sydney, Australia
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10
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Lew BJ, McCusker MC, O'Neill J, Bares SH, Wilson TW, Doucet GE. Resting state network connectivity alterations in HIV: Parallels with aging. Hum Brain Mapp 2023; 44:4679-4691. [PMID: 37417797 PMCID: PMC10400792 DOI: 10.1002/hbm.26409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 05/10/2023] [Accepted: 06/12/2023] [Indexed: 07/08/2023] Open
Abstract
The increasing incidence of age-related comorbidities in people with HIV (PWH) has led to accelerated aging theories. Functional neuroimaging research, including functional connectivity (FC) using resting-state functional magnetic resonance imaging (rs-fMRI), has identified neural aberrations related to HIV infection. Yet little is known about the relationship between aging and resting-state FC in PWH. This study included 86 virally suppressed PWH and 99 demographically matched controls spanning 22-72 years old who underwent rs-fMRI. The independent and interactive effects of HIV and aging on FC were investigated both within- and between-network using a 7-network atlas. The relationship between HIV-related cognitive deficits and FC was also examined. We also conducted network-based statistical analyses using a brain anatomical atlas (n = 512 regions) to ensure similar results across independent approaches. We found independent effects of age and HIV in between-network FC. The age-related increases in FC were widespread, while PWH displayed further increases above and beyond aging, particularly between-network FC of the default-mode and executive control networks. The results were overall similar using the regional approach. Since both HIV infection and aging are associated with independent increases in between-network FC, HIV infection may be associated with a reorganization of the major brain networks and their functional interactions in a manner similar to aging.
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Affiliation(s)
- Brandon J. Lew
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- College of MedicineUniversity of Nebraska Medical Center (UNMC)OmahaNebraskaUSA
| | - Marie C. McCusker
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- Interdepartmental Neuroscience ProgramYale University School of MedicineNew HavenConnecticutUSA
| | - Jennifer O'Neill
- Department of Internal Medicine, Division of Infectious DiseasesUNMCOmahaNebraskaUSA
| | - Sara H. Bares
- Department of Internal Medicine, Division of Infectious DiseasesUNMCOmahaNebraskaUSA
| | - Tony W. Wilson
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- College of MedicineUniversity of Nebraska Medical Center (UNMC)OmahaNebraskaUSA
- Department of Pharmacology & NeuroscienceCreighton UniversityOmahaNebraskaUSA
| | - Gaelle E. Doucet
- Institute for Human NeuroscienceBoys Town National Research HospitalOmahaNebraskaUSA
- Department of Pharmacology & NeuroscienceCreighton UniversityOmahaNebraskaUSA
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11
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Spagnolo-Allende A, Schnall R, Liu M, Igwe KC, Laing KK, Chesebro AG, Brickman AM, Gutierrez J. Serum inflammation markers associated with altered brain white matter microstructure in people with HIV on antiretroviral treatment. Neurol Sci 2023; 44:2159-2166. [PMID: 36710283 PMCID: PMC10635284 DOI: 10.1007/s10072-023-06613-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 01/11/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Many studies have reported reduced brain white matter fractional anisotropy (FA) and increased mean diffusivity (MD) on diffusion tensor imaging (DTI) of people with HIV (PWH). Few, however, have linked individual blood inflammatory markers with white matter tract-specific FA and MD. METHODS PWH 50 years old or older from New York, NY, USA, were invited to a cross-sectional study. Demographic data, blood samples, and brain DTI were obtained. Least absolute shrinkage and selection operator (LASSO) regression was used to examine associations between biomarkers and white matter tract-specific FA and MD. All models included age, sex, race, ethnicity, diabetes, hypertension, smoking, and viral load as control variables. RESULTS Seventy-two cases were analyzed. Mean age was 60 ± 6 years, 47% were women, 21% were Hispanic, and 78% were black. All had asymptomatic HIV infection and were on antiretroviral therapy. Eighty-nine percent had CD4 count >200 cell/mm3 and 78% were virally suppressed. Vascular endothelial growth factor (VEGF) and macrophage inflammatory proteins (MIP) 1β and 1α were consistently associated with lower FA and higher MD across white matter tracts. CONCLUSIONS Elevated serum VEGF, MIP-1α, and MIP-1β were associated with altered white matter microstructure. These blood biomarkers may help predict HIV-associated white matter damage.
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Affiliation(s)
- Antonio Spagnolo-Allende
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA
| | - Rebecca Schnall
- School of Nursing, Columbia University Irving Medical Center, New York, NY, USA
- Department of Population and Family Health, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
| | - Minghua Liu
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA
| | - Kay C Igwe
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA
| | - Krystal K Laing
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA
| | - Anthony G Chesebro
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA
| | - Adam M Brickman
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, 710 W 168Th Street, 6Th Floor, New York, NY, 10032, USA.
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12
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Mamidi RS, Ayubcha C, Rigney G, Kirschner J, Gerke O, Werner TJ, Tebas P, Alavi A, Revheim ME. A prospective 18 F-fluorodeoxyglucose positron emission tomography/computed tomography study of the neurometabolic effects in cocaine use and HIV infection. AIDS 2023; 37:905-912. [PMID: 36727840 PMCID: PMC10090338 DOI: 10.1097/qad.0000000000003485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 12/25/2022] [Accepted: 01/11/2023] [Indexed: 02/03/2023]
Abstract
OBJECTIVES HIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in cocaine users with HIV infection. DESIGN Sixty-three participants were categorized into groups: 36 HIV infected (HIV+) and 27 non-HIV infected (HIV-) individuals. Each group was further split into cocaine users (CO+) and non-cocaine users (CO-). Of the HIV+, half were cocaine users and half were not. Of the HIV-, 14 were cocaine users and 13 were not. 18 F-FDG-PET and low dose CT scans were performed on all participants. METHODS Brain glucose metabolism was evaluated by 18 F-FDG uptake in the whole brain, cortex, basal ganglia, and cerebellum 120 min after injection. ROVER software was used for image analysis and regions of interest masks were applied via an adaptive threshold system. ANOVA tests and t -tests were performed to assess the respective differences between the four groups. RESULTS Generally, the HIV+/CO+ group (group A) displayed the lowest levels of uptake whereas the HIV-/CO- group (group D) showed the highest; the HIV+/CO- and HIV-/CO+ groups (groups B and C) showed intermediate levels of activity across the whole brain, cortex, basal ganglia, and cerebellum. CONCLUSION HIV infection and cocaine usage were independently associated with a decrease in brain glucose uptake as measured by 18 F-FDG PET/CT. When combined, positive HIV status and cocaine patients showed the most decreased 18 F-FDG uptake.
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Affiliation(s)
- Ramya S. Mamidi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Jason Kirschner
- Division of Infectious Diseases/Clinical Trials Unit, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Oke Gerke
- Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark
| | - Thomas J. Werner
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Pablo Tebas
- Division of Infectious Diseases/Clinical Trials Unit, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mona-Elisabeth Revheim
- Division of Radiology and Nuclear Medicine, Oslo University Hospital
- Faculty of Medicine, University of Oslo, Oslo, Norway
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13
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Kowo-Nyakoko F, Gregson CL, Madanhire T, Stranix-Chibanda L, Rukuni R, Offiah AC, Micklesfield LK, Cooper C, Ferrand RA, Rehman AM, Ward KA. Evaluation of two methods of bone age assessment in peripubertal children in Zimbabwe. Bone 2023; 170:116725. [PMID: 36871897 DOI: 10.1016/j.bone.2023.116725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Bone age (BA) measurement in children is used to evaluate skeletal maturity and helps in the diagnosis of growth disorders in children. The two most used methods are Greulich and Pyle (GP), and Tanner and Whitehouse 3 (TW3), both based upon assessment of a hand-wrist radiograph. To our knowledge no study has compared and validated the two methods in sub-Saharan Africa (SSA), and only a few have determined BA despite it being a region where skeletal maturity is often impaired for example by HIV and malnutrition. This study aimed to compare BA as measured by two methods (GP and TW3) against chronological age (CA) and determine which method is most applicable in peripubertal children in Zimbabwe. METHODS We conducted a cross-sectional study of boys and girls who tested negative for HIV. Children and adolescents were recruited by stratified random sampling from six schools in Harare, Zimbabwe. Non-dominant hand-wrist radiographs were taken, and BA assessed manually using both GP and TW3. Paired sample Student t-tests were used to calculate the mean differences between BA and chronological age (CA) in boys and girls. Bland-Altman plots compared CA to BA as determined by both methods, and agreement between GP and TW3 BA. All radiographs were graded by a second radiographer and 20 % of participants of each sex were randomly selected and re-graded by the first observer. Intraclass correlation coefficient assessed intra- and inter-rater reliability and coefficient of variation assessed precision. RESULTS We recruited 252 children (111 [44 %] girls) aged 8.0-16.5 years. The boys and girls were of similar mean ± SD CA (12.2 ± 2.4 and 11.7 ± 1.9 years) and BA whether assessed by GP (11.5 ± 2.8 and 11.5 ± 2.1 years) or TW3 (11.8 ± 2.5 and 11.8 ± 2.1 years). In boys BA was lower than CA by 0.76 years (95 % CI: -0.95, -0.57) when using GP, and by 0.43 years (95 % CI: -0.61, -0.24) when using TW3. Among the girls there was no difference between BA and CA by either GP [-0.19 years (95 % CI: -0.40, 0.03)] or TW3 [0.07 years (95 % CI: -0.16, 0.29)]. In both boys and girls, there were no systematic differences between CA and TW3 BA across age groups whereas agreement improved between CA and GP BA as children got older. Inter-operator precision was 1.5 % for TW3 and 3.7 % for GP (n = 252) and intra-operator precision was 1.5 % for TW3 and 2.4 % for GP (n = 52). CONCLUSION The TW3 BA method had better precision than GP and did not systematically differ from CA, meaning that TW3 is the preferred method of assessment of skeletal maturity in Zimbabwean children and adolescents. TW3 and GP methods do not agree for estimates of BA and therefore cannot be used interchangeably. The systematic differences in GP BA assessments over age means it is not appropriate for use in all age groups or stages of maturity in this population.
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Affiliation(s)
- Farirayi Kowo-Nyakoko
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD Southampton, UK; Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe; Department of Medical Physics and Imaging Sciences, University of Zimbabwe- Faculty of Medicine and Health Sciences, Parirenyatwa Group of Hospitals, Mazowe Street, Harare, Zimbabwe.
| | - Celia L Gregson
- Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol BS10 5NB, UK; SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tafadzwa Madanhire
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe
| | - Lynda Stranix-Chibanda
- Child and Adolescent Unit, University of Zimbabwe-Faculty of Medicine and Health Sciences, Parirenyatwa Group of Hospitals, Mazowe Street, Harare, Zimbabwe
| | - Ruramayi Rukuni
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Amaka C Offiah
- Department of Oncology & Metabolism, University of Sheffield, Damer Street Building, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield S10 2TH, UK
| | - Lisa K Micklesfield
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD Southampton, UK
| | - Rashida A Ferrand
- Biomedical Research and Training Institute, 10 Seagrave Road, Avondale Harare, Zimbabwe; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrea M Rehman
- MRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, SO16 6YD Southampton, UK; SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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14
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Al-Khalil K, Bell RP, Towe SL, Gadde S, Burke E, Meade CS. Cortico-striatal networking deficits associated with advanced HIV disease and cocaine use. J Neurovirol 2023; 29:167-179. [PMID: 36809507 PMCID: PMC10515399 DOI: 10.1007/s13365-023-01120-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/23/2023]
Abstract
Cocaine use is disproportionately prevalent in people with HIV (PWH) and is known to potentiate HIV neuropathogenesis. As both HIV and cocaine have well-documented cortico-striatal effects, PWH who use cocaine and have a history of immunosuppression may exhibit greater FC deficits compared to PWH without these conditions. However, research investigating the legacy effects of HIV immunosuppression (i.e., a history of AIDS) on cortico-striatal functional connectivity (FC) in adults with and without cocaine use is sparse. Resting-state functional magnetic resonance imaging (fMRI) and neuropsychological assessment data from 273 adults were analyzed to examine FC in relation to HIV disease: HIV-negative (n = 104), HIV-positive with nadir CD4 ≥ 200 (n = 96), HIV-positive with nadir CD4 < 200 (AIDS; n = 73), and cocaine use (83 COC and 190 NON). Using independent component analysis/dual regression, FC was assessed between the basal ganglia network (BGN) and five cortical networks: dorsal attention network (DAN), default mode network, left executive network, right executive network, and salience network. There were significant interaction effects such that AIDS-related BGN-DAN FC deficits emerged in COC but not in NON participants. Independent of HIV, cocaine effects emerged in FC between the BGN and executive networks. Disruption of BGN-DAN FC in AIDS/COC participants is consistent with cocaine potentiation of neuro-inflammation and may be indicative of legacy HIV immunosuppressive effects. The current study bolsters previous findings linking HIV and cocaine use with cortico-striatal networking deficits. Future research should consider the effects of the duration of HIV immunosuppression and early treatment initiation.
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Affiliation(s)
- Kareem Al-Khalil
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA.
| | - Ryan P Bell
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Sheri L Towe
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Syam Gadde
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27710, USA
| | - Emma Burke
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Christina S Meade
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
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15
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Huyck M, Mayer S, Messmer S, Yingling C, Stephenson S. Ultrasound-guided phlebotomy in primary care for people who inject drugs. Harm Reduct J 2023; 20:36. [PMID: 36959607 PMCID: PMC10035178 DOI: 10.1186/s12954-023-00762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVES Persons who inject drugs (PWID) commonly experience venous degradation as a complication of prolonged injection, which makes routine phlebotomy difficult. Clients may decline care due to the perceived lack of skilled phlebotomy services, and this contributes to significant delays in infectious disease screening and treatment. In this study, we investigated ultrasound-guided phlebotomy in clients with difficult venous access receiving care at two low-threshold buprenorphine clinics. Our objectives were to increase the accuracy of vascular access, expedite infectious disease treatment for hepatitis C virus (HCV) and human immunodeficiency virus (HIV), and increase client satisfaction with phlebotomy services. METHODS PWID who declined routine phlebotomy at two clinic sites were offered ultrasound-guided vascular access by a trained clinician. Participants completed a survey to collect data regarding acceptability of the intervention. RESULTS Throughout a 14-month period, 17 participants were enrolled. Of the total 30 procedures, 41.2% of clients returned for more than one phlebotomy visit, and 88.2% of clients achieved vascular access within 1 attempt. Of participating clients, 52.9% described themselves as having difficult venous access and at conclusion of the study, 58.8% expressed more willingness to have phlebotomy performed with an ultrasound device. CONCLUSIONS Offering ultrasound-guided phlebotomy for PWID with difficult venous access resulted in decreased access attempts, increased patient satisfaction, and expedited screening and treatment for HIV and HCV point-of-care ultrasound technology is an effective approach to improving care for persons who inject drugs.
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Affiliation(s)
- Michael Huyck
- University of Illinois at Chicago (UIC) School of Nursing, Chicago, USA.
| | - Stockton Mayer
- Department of Infectious Disease, UIC College of Medicine, Chicago, USA
| | - Sarah Messmer
- Department of Pediatrics, UIC College of Medicine, Chicago, USA
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16
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van Genderen JG, Verkade CR, Van den Hof M, Demirkaya N, Schrantee AGM, Verbraak FD, Pajkrt D. Development of retinal structure in perinatally HIV-infected children and adolescents: A longitudinal and cross-sectional assessment. PLoS One 2023; 18:e0282284. [PMID: 36862721 PMCID: PMC9980730 DOI: 10.1371/journal.pone.0282284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/12/2023] [Indexed: 03/03/2023] Open
Abstract
In perinatally HIV-infected (PHIV) children, cross-sectional studies reported on subtle structural retinal differences and found associations between the retina and structural brain changes. Our objective is to investigate whether neuroretinal development in PHIV children is similar to the development in healthy matched controls and to explore associations with the brain structure. We measured RT using optical coherence tomography (OCT) on two occasions in 21 PHIV children or adolescents and 23 matched controls-all with good visual acuity-with a mean interval of 4.6 years (SD 0.3). We also included 22 participants (11 PHIV children and 11 controls) together with the follow-up group for a cross-sectional assessment using a different OCT device. Magnetic resonance imaging (MRI) was used to assess the white matter microstructure. We used linear (mixed) models to assess changes in RT and its determinants (over time), adjusting for age and sex. The development of the retina was similar between the PHIV adolescents and controls. In our cohort, we found that changes in the peripapillary RNFL was significantly associated with changes in WM microstructural makers: fractional anisotropy (coefficient = 0.030, p = 0.022) and radial diffusivity (coefficient = -0.568, p = 0.025). We found comparable RT between groups. A thinner pRNFL was associated with lower WM volume (coefficient = 0.117, p = 0.030). PHIV children or adolescents appear to have a similar development of the retinal structure. In our cohort, the associations between RT and MRI biomarkers underscore the relation between retina and brain.
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Affiliation(s)
- Jason G. van Genderen
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Charissa R. Verkade
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Malon Van den Hof
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Nazli Demirkaya
- Department of Ophthalmology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Anouk G. M. Schrantee
- Department of Radiology and Nuclear Medicine, Location Academic Medical Center, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Frank D. Verbraak
- Department of Ophthalmology, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital, Amsterdam UMC, Location Academic Medical Center, Amsterdam, the Netherlands
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17
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Boczar KE, Faller E, Zeng W, Wang J, Small GR, Corrales-Medina VF, deKemp RA, Ward NC, Beanlands RSB, MacPherson P, Dwivedi G. Anti-inflammatory effect of rosuvastatin in patients with HIV infection: An FDG-PET pilot study. J Nucl Cardiol 2022; 29:3057-3068. [PMID: 34820771 DOI: 10.1007/s12350-021-02830-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/22/2021] [Indexed: 01/29/2023]
Abstract
AIMS This study aimed to evaluate markers of systemic as well as imaging markers of inflammation in the ascending aorta, bone marrow, and spleen measured by 18F-FDG PET/CT, in HIV+ patients at baseline and following therapy with rosuvastatin. METHODS AND RESULTS Of the 35 HIV+ patients enrolled, 17 were randomized to treatment with 10 mg/day rosuvastatin and 18 to usual care for 6 months. An HIV- control cohort was selected for baseline comparison of serum inflammatory markers and monocyte markers of inflammation. 18F-FDG-PET/CT imaging of bone marrow, spleen, and thoracic aorta was performed in the HIV+ cohort at baseline and 6 months. While CD14++CD16- and CCR2 expressions were reduced, serum levels of IL-7, IL-8, and MCP-1 were elevated in the HIV+ population compared to the controls. There was a significant drop in FDG uptake in the bone marrow (TBRmax), spleen (SUVmax) and thoracic aortic (TBRmax) in the statin-treated group compared to the control group (bone marrow: - 10.3 ± 16.9% versus 5.0 ± 18.9%, p = .0262; spleen: - 9.8 ± 20.3% versus 11.3 ± 28.8%, p = .0497; thoracic aorta: - 19.1 ± 24.2% versus 4.3 ± 15.4%, p = .003). CONCLUSIONS HIV+ patients had significantly markers of systemic inflammation including monocyte activation. Treatment with low-dose rosuvastatin in the HIV+ cohort significantly reduced bone marrow, spleen and thoracic aortic FDG uptake.
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Affiliation(s)
- Kevin E Boczar
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Elliot Faller
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Wanzhen Zeng
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jerry Wang
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Gary R Small
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Vicente F Corrales-Medina
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Robert A deKemp
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Natalie C Ward
- School of Public Health, Curtin University, Perth, Australia
- School of Medicine, University of Western Australia, Perth, Australia
| | - Rob S B Beanlands
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Paul MacPherson
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Girish Dwivedi
- Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
- School of Medicine, University of Western Australia, Perth, Australia.
- Department of Advanced Clinical and Translational Cardiovascular Imaging, Harry Perkins Institute of Medical Research, The University of Western Australia, Murdoch, Australia.
- Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA, 6009, Australia.
- School of Biomedical Sciences at Curtin University, Perth, WA, Australia.
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18
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Timtim SH, Simmons AN, Hays C, Strigo I, Sorg S, Ellis R, Keltner JR. HIV peripheral neuropathy-related degeneration of white matter tracts to sensorimotor cortex. J Neurovirol 2022; 28:505-513. [PMID: 36207560 PMCID: PMC9797459 DOI: 10.1007/s13365-022-01051-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 01/02/2022] [Accepted: 01/11/2022] [Indexed: 01/13/2023]
Abstract
Human immunodeficiency virus-associated distal sensory polyneuropathy (HIV-DSP) affects up to 50% of people with HIV and is associated with depression, unemployment, and generally worsened quality of life. Previous work on the cortical mechanism of HIV neuropathy found decreased gray matter volume in the bilateral midbrain, thalamus, and posterior cingulate cortex, but structural connectivity in this context remains under-studied. Here we examine alterations in white matter microstructure using diffusion imaging, hypothesizing that cortical white matter degeneration would be observed in continuation of the peripheral white matter atrophy previously observed in HIV-DSP. Male HIV seropositive patients (n = 57) experiencing varying degrees of HIV neuropathy underwent single-shell diffusion tensor imaging with 51 sampling directions. The scans were pooled using tractography and connectometry to create a quantitative map of white matter tract integrity, measured in generalized fractional anisotropy (GFA). The relationship between GFA and neuropathy severity was evaluated with linear regression. Correction for multiple comparisons was done using false discovery rate (FDR), a statistical method commonly used in genomics and imaging to minimize false positives when thousands of individual comparisons are made. Neuropathy severity was associated with decreased GFA along thalamocortical radiations leading along the lateral thalamus to sensorimotor cortex, with r = -0.405 (p < 0.001; FDR), as well as with the superior bilateral cingulum (r = -0.346 (p < 0.05; FDR)). Among a population of HIV neuropathy patients, greater neuropathy severity was correlated with lower white matter integrity running from midbrain to somatosensory cortex. This suggests ascending deafferentation extending from damaged peripheral nerves further downstream than seen previously, into the axons of third-order neurons. There is also evidence of cingulum degeneration, implying some more complex mechanism beyond the ascending atrophy observed here.
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Affiliation(s)
- Sara H Timtim
- UCSD, University of California San Diego School of Medicine, San Diego, CA, USA.
| | - Alan N Simmons
- UCSD, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Chelsea Hays
- UCSD, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Irina Strigo
- UCSF, University of California San Francisco School of Medicine, San Francisco, CA, USA
| | - Scott Sorg
- UCSD, University of California San Diego School of Medicine, San Diego, CA, USA
| | - Ronald Ellis
- UCSD, University of California San Diego School of Medicine, San Diego, CA, USA
| | - John R Keltner
- UCSD, University of California San Diego School of Medicine, San Diego, CA, USA
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19
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Law-Ye B, de Truchis P, Peyrassou D, Force G, Carlier RY. Elevation of brain ADC (apparent diffusion coefficient) in HIV-associated neurocognitive disorders and evolution after treatment: A pilot study. J Neurol Sci 2022; 442:120446. [PMID: 36265262 DOI: 10.1016/j.jns.2022.120446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/05/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Thirty to 50% of HIV-infected patients develop HIV-Associated Neurocognitive Disorders (HAND) despite virological control. The previously published Neuro+3 study showed their neurocognitive status can be improved by intensifying antiviral therapy. Our study is a part of the Neuro3+ study and aims to study apparent diffusion coefficient (ADC) as a biomarker for neurological improvement. PATIENTS AND METHODS We prospectively included 31 patients with HAND. They received therapy with better CNS Penetration Effectiveness (CPE) score with two-year follow-up. Cognitive status was assessed at day 0 (D0) and week 96 (W96) using Frascati 3-stage classification and Global Deficit Score (GDS). Brain MRI at D0 and W96 assessed morphological data (white matter hyperintensities, opportunistic infections, ischemic lesions, atrophy) and measured whole brain apparent diffusion coefficient (ADC). We compared their data with a control group of 20 healthy patients with similar ages and sex ratio. RESULTS After ARV intensification, cognitive status was significantly improved: GDS (n = 1,4 vs 1,0 p = 0.01) and Frascati scale (2HAD/22MND/7ANI vs 1HAD/8MND/17ANI p = 0.001). Mean ADC was significantly higher in patients at inclusion than in controls (0.88 × 10-3 mm2/s ± 0.06 vs 0.81 × 10-3 mm2/s ± 0.04, p = 0.0001). ADC decreased after treatment (0.88 × 10-3 mm2/s ± 0.06 vs 0.85 × 10-3 mm2/s ± 0.06 (p = 0,04). In subgroup analysis, ADC significantly decreased in clinically improved patients (0.89 × 10-3 mm2/s ± 0.07 vs 0.85 × 10-3 mm2/s ± 0.07 (p = 0,03)) and did not significantly change in non-clinically improved patients (0.86 × 10-3 mm2/s ± 0.07 vs 0.84 × 10-3 mm2/s ± 0.07 (p = 0,31)). After treatment, there was no significant difference between patients and controls (0.85 × 10-3 mm2/s ± 0.06 vs 0.81 × 10-3 mm2/s ± 0.04, p = 0.17). CONCLUSION Whole-brain ADC is a good biomarker of HIV-associated neurocognitive disorders. It is significantly increased in patients with HAND compared with controls and significantly decreases after treatment. It is all the more important to have a quantitative biomarker as conventional imaging does not contribute to the diagnosis.
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Affiliation(s)
- Bruno Law-Ye
- Neuroradiology Department, Pitié-Salpêtrière University Hospital, APHP, Paris, France.
| | - Pierre de Truchis
- Infectiology Department, Garches University Hospital, Garches, France; UMR 1179, UVSQ-Paris-Saclay University, France
| | - David Peyrassou
- Radiology Department, DMU Smart Imaging, Raymond Poincaré University Hospital, APHP, Garches, France
| | - Gilles Force
- Infectiology Department, Garches University Hospital, Garches, France
| | - Robert-Yves Carlier
- Radiology Department, DMU Smart Imaging, Raymond Poincaré University Hospital, APHP, Garches, France; APHP-Université Paris-Saclay, Garches, France
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20
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Roberts JA, Shen Y, Strehlau R, Patel F, Kuhn L, Coovadia A, Kaufman JJ, Shiau S, Arpadi SM, Yin MT. Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV. PLoS One 2022; 17:e0276290. [PMID: 36251674 PMCID: PMC9576091 DOI: 10.1371/journal.pone.0276290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Children living with HIV (CLHIV) have decreased bone mineral content (BMC) and density (BMD), increasing risk for fracture and future osteoporosis. While DXA is the gold-standard for bone assessments, it lacks availability in resource-constrained settings (RCS). Quantitative ultrasound (QUS) offers an alternative owing to its portability, low cost, ease of handling, and lack of ionizing radiation. While QUS has detected reduced bone quality in CLHIV, the relationship between QUS and DXA in this population remains unexplored. At baseline and 12 months, BMC and BMD of the whole body, lumbar spine, and radius were measured by DXA in a longitudinal cohort of CLHIV in Johannesburg, South Africa. Calcaneal speed of sound (SOS) and broadband ultrasound attenuation (BUA) and radius SOS were obtained by QUS, and calcaneal stiffness index (SI) was calculated. Spearman correlations, with and without HIV stratification, were performed between QUS and DXA measurements at each visit and for absolute difference in measurements between visits. At baseline and 12-months, calcaneal BUA and SI displayed strong positive correlations with DXA, with only modest correlations between radial QUS and DXA at baseline. Longitudinal measures of QUS did not correlate with DXA. At both baseline and 12-months, individuals with DXA whole-body BMD z-score < -1 displayed significantly lower calcaneal BUA and SI. Cross-sectionally, calcaneal QUS correlates strongly with whole body DXA and may represent a viable diagnostic alternative in RCS. Longitudinally, the two methods do not correlate well, possibly reflecting that each method assesses distinct aspects of bone architecture.
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Affiliation(s)
- Jackson A. Roberts
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America
| | - Yanhan Shen
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Renate Strehlau
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Ashraf Coovadia
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonathan J. Kaufman
- Cyberlogic, Inc., New York, New York, United States of America
- Department of Orthopedics, The Mount Sinai Medical Center, New York, New York, United States of America
| | - Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Stephen M. Arpadi
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Michael T. Yin
- Division of Infectious Disease, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
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Wakim KM, Freedman EG, Tivarus ME, Christensen Z, Molholm S, Foxe JJ. Effects of Human Immunodeficiency Virus Infection and Former Cocaine Dependence on Neuroanatomical Measures and Neurocognitive Performance. Neuroscience 2022; 502:77-90. [PMID: 35963584 PMCID: PMC9588737 DOI: 10.1016/j.neuroscience.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022]
Abstract
Evidence from animal research, postmortem analyses, and magnetic resonance imaging (MRI) investigations indicate substantial morphological alteration in brain structure as a function of human immunodeficiency virus (HIV) or cocaine dependence (CD). Although previous research on HIV+ active cocaine users suggests the presence of deleterious morphological effects in excess of either condition alone, a yet unexplored question is whether there is a similar deleterious interaction in HIV+ individuals with CD who are currently abstinent. To this end, the combinatorial effects of HIV and CD history on regional brain volume, cortical thickness, and neurocognitive performance was examined across four groups of participants in an exploratory study: healthy controls (n = 34), HIV-negative individuals with a history of CD (n = 21), HIV+ individuals with no history of CD (n = 20), HIV+ individuals with a history of CD (n = 15). Our analyses revealed no statistical evidence of an interaction between both conditions on brain morphometry and neurocognitive performance. While descriptively, individuals with comorbid HIV and a history of CD exhibited the lowest neurocognitive performance scores, using Principle Component Analysis of neurocognitive testing data, HIV was identified as the primary driver of neurocognitive impairment. Higher caudate volume was evident in CD+ participants relative to CD- participants. Findings indicate no evidence of compounded differences in neurocognitive function or structural measures of brain integrity in HIV+ individuals in recovery from CD relative to individuals with only one condition.
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Affiliation(s)
- Kathryn-Mary Wakim
- The Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Edward G Freedman
- The Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Madalina E Tivarus
- The Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA; Department of Imaging Sciences, University of Rochester, Rochester, NY, USA
| | - Zachary Christensen
- The Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Sophie Molholm
- Department of Neuroscience, Albert Einstein College of Medicine, New York, NY, USA
| | - John J Foxe
- The Cognitive Neurophysiology Laboratory, The Del Monte Institute for Neuroscience, Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
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22
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van Genderen JG, Chia C, Van den Hof M, Mutsaerts HJMM, Reneman L, Pajkrt D, Schrantee A. Brain Differences in Adolescents Living With Perinatally Acquired HIV Compared With Adoption Status Matched Controls: A Cross-sectional Study. Neurology 2022; 99:e1676-e1684. [PMID: 35940898 PMCID: PMC9559945 DOI: 10.1212/wnl.0000000000200946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Despite effective combination antiretroviral therapy (cART), adolescents with perinatally acquired HIV (PHIV) exhibit cognitive impairment, of which structural changes could be the underlying pathophysiologic mechanism. Prior MRI studies found lower brain volumes, higher white matter (WM) hyperintensity (WMH) volume, lower WM integrity, and differences in cerebral blood flow (CBF). However, these findings may be confounded by adoption status, as a large portion of adolescents with PHIV have been adopted. Adoption has been associated with malnutrition and neglect, which, in turn, may have affected brain development. We investigated the long-term effects of PHIV on the brain, while minimizing the confounding effect of adoption status. METHODS We determined whole-brain gray matter (GM) and WM volume with 3D T1-weighted scans; total WMH volume with fluid-attenuated inversion recovery; CBF in the following regions of interest (ROIs): WM, GM, and subcortical GM with arterial spin labeling; and whole-brain WM microstructural markers: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) with diffusion tensor imaging in cART-treated adolescents with PHIV visiting our outpatient clinic in Amsterdam and controls matched for age, sex, ethnic origin, socioeconomic status, and adoption status. We assessed differences in neuroimaging parameters between adolescents with PHIV and controls using linear regression models adjusted for age and sex and applied multiple comparison correction. RESULTS Thirty-five adolescents with PHIV and 38 controls were included with a median age of 14.9 (interquartile range [IQR]: 10.7-18.5) and 15.6 (IQR: 11.1-17.6) years, respectively, with a similar rate of adoption. We found a lower overall FA (beta = -0.012; p < 0.014, -2.4%), a higher MD (beta = 0.014, p = 0.014, 1.3%), and a higher RD (beta = 0.02, p = 0.014, 3.3%) in adolescents with PHIV vs adoption-matched controls, but no differences in AD. We found comparable GM, WM, and WMH volume and CBF in ROIs between adolescents with PHIV and controls. We did not find an association between cognitive profiles and WM microstructural markers in adolescents with PHIV. DISCUSSION Irrespective of adoption status, adolescents with PHIV exhibited subtle lower WM integrity. Our findings may point toward early-acquired WM microstructural alterations associated with HIV.
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Affiliation(s)
- Jason G van Genderen
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands.
| | - Cecilia Chia
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands
| | - Malon Van den Hof
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands
| | - Henk J M M Mutsaerts
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands
| | - Liesbeth Reneman
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands
| | - Dasja Pajkrt
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands
| | - Anouk Schrantee
- From the Department of Pediatric Infectious Diseases (J.G.G., C.C., M.V.H., D.P.), Emma Children's Hospital, Amsterdam UMC, Location Academic Medical Center, the Netherlands; Department of Radiology and Nuclear Medicine (H.J.M.M.M.), Amsterdam University Medical Centers, Location VU Medical Center, University of Amsterdam, the Netherlands; and Department of Radiology and Nuclear Medicine (L.R., A.S.), Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, the Netherlands
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23
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Khobo IL, Jankiewicz M, Holmes MJ, Little F, Cotton MF, Laughton B, van der Kouwe AJW, Moreau A, Nwosu E, Meintjes EM, Robertson FC. Multimodal magnetic resonance neuroimaging measures characteristic of early cART-treated pediatric HIV: A feature selection approach. Hum Brain Mapp 2022; 43:4128-4144. [PMID: 35575438 PMCID: PMC9374890 DOI: 10.1002/hbm.25907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/03/2022] [Accepted: 04/26/2022] [Indexed: 11/09/2022] Open
Abstract
Children with perinatally acquired HIV (CPHIV) have poor cognitive outcomes despite early combination antiretroviral therapy (cART). While CPHIV-related brain alterations can be investigated separately using proton magnetic resonance spectroscopy (1 H-MRS), structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI), and functional MRI (fMRI), a set of multimodal MRI measures characteristic of children on cART has not been previously identified. We used the embedded feature selection of a logistic elastic-net (EN) regularization to select neuroimaging measures that distinguish CPHIV from controls and measured their classification performance via the area under the receiver operating characteristic curve (AUC) using repeated cross validation. We also wished to establish whether combining MRI modalities improved the models. In single modality analysis, sMRI volumes performed best followed by DTI, whereas individual EN models on spectroscopic, gyrification, and cortical thickness measures showed no class discrimination capability. Adding DTI and 1 H-MRS in basal measures to sMRI volumes produced the highest classification performancevalidation accuracy = 85 % AUC = 0.80 . The best multimodal MRI set consisted of 22 DTI and sMRI volume features, which included reduced volumes of the bilateral globus pallidus and amygdala, as well as increased mean diffusivity (MD) and radial diffusivity (RD) in the right corticospinal tract in cART-treated CPHIV. Consistent with previous studies of CPHIV, select subcortical volumes obtained from sMRI provide reasonable discrimination between CPHIV and controls. This may give insight into neuroimaging measures that are relevant in understanding the effects of HIV on the brain, thereby providing a starting point for evaluating their link with cognitive performance in CPHIV.
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Affiliation(s)
- Isaac L. Khobo
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| | - Marcin Jankiewicz
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Cape Universities Body Imaging CenterUniversity of Cape TownCape TownSouth Africa
| | - Martha J. Holmes
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
| | - Francesca Little
- Department of Statistical SciencesUniversity of Cape TownCape TownSouth Africa
| | - Mark F. Cotton
- Department of Pediatrics & Child Health, Family Center for Research with Ubuntu, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - Barbara Laughton
- Department of Pediatrics & Child Health, Family Center for Research with Ubuntu, Tygerberg HospitalStellenbosch UniversityCape TownSouth Africa
| | - Andre J. W. van der Kouwe
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
- A.A. Martinos Centre for Biomedical ImagingMassachusetts General HospitalBostonMassachusettsUSA
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Emmanuel Nwosu
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
| | - Ernesta M. Meintjes
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Cape Universities Body Imaging CenterUniversity of Cape TownCape TownSouth Africa
| | - Frances C. Robertson
- Division of Biomedical Engineering, Department of Human Biology, Biomedical Engineering Research CenterUniversity of Cape TownCape TownSouth Africa
- Neuroscience InstituteUniversity of Cape TownCape TownSouth Africa
- Cape Universities Body Imaging CenterUniversity of Cape TownCape TownSouth Africa
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24
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Chan P, Spudich S. Investigating vascular diseases in people living with HIV by nuclear imaging. J Nucl Cardiol 2022; 29:1576-1582. [PMID: 33884573 DOI: 10.1007/s12350-021-02613-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Phillip Chan
- SEARCH, Institute of HIV Research and Innovation, Bangkok, Thailand
| | - Serena Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
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Beyhan E, Erol Fenercioğlu Ö, Şahin R, Baloğlu MC, Çermik TF. 18F-FDG PET/CT Findings in HIV-Positive Patient With Primary Pancreas Lymphoma and CMV Pancreatitis. Clin Nucl Med 2022; 47:e393-e394. [PMID: 35195582 DOI: 10.1097/rlu.0000000000004109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT A 35-year-old HIV-positive man with abdominal pain was referred to 18F-FDG PET/CT for metabolic characterization of mass in pancreas. PET/CT images showed intense FDG uptake in head of the pancreas, as well as diffuse moderate uptake throughout body and tail of the pancreas. Histopathological results revealed Epstein-Barr virus (EBV) associated large B-cell lymphoma and pancreatitis caused by cytomegalovirus.
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Affiliation(s)
- Ediz Beyhan
- From the Clinic of Nuclear Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
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26
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Young JW, Barback CV, Stolz LA, Groman SM, Vera DR, Hoh C, Kotta KK, Minassian A, Powell SB, Brody AL. MicroPET evidence for a hypersensitive neuroinflammatory profile of gp120 mouse model of HIV. Psychiatry Res Neuroimaging 2022; 321:111445. [PMID: 35101828 DOI: 10.1016/j.pscychresns.2022.111445] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 02/07/2023]
Abstract
Despite increased survivability for people living with HIV (PLWH), HIV-related cognitive deficits persist. Determining biological mechanism(s) underlying abnormalities is critical to minimize the long-term impact of HIV. Positron emission tomography (PET) studies reveal that PLWH exhibit elevated neuroinflammation, potentially contributing to these problems. PLWH are hypersensitive to environmental insults that drive elevated inflammatory profiles. Gp120 is an envelope glycoprotein exposed on the surface of the HIV envelope which enables HIV entry into a cell contributing to HIV-related neurotoxicity. In vivo evidence for mice overexpressing gp120 (transgenic) mice exhibiting neuroinflammation remains unclear. Here, we conducted microPET imaging in gp120 transgenic and wildtype mice, using the radiotracer [(18)F]FEPPA (binds to the translocator protein expressed by activated microglial serving as a neuroinflammatory marker). Imaging was performed at baseline and 24 h after lipopolysaccharide (LPS; 5 mg/kg) treatment (endotoxin that triggers an immune response). Gp120 transgenic mice exhibited elevated [(18F)]FEPPA in response to LPS vs. wildtype mice throughout the brain including dorsal and ventral striata, hypothalamus, and hippocampus. Gp120 transgenic mice are hypersensitive to environmental inflammatory insults, consistent with PLWH, measurable in vivo. It remains to-be-determined whether this heightened sensitivity is connected to the behavioral abnormalities of these mice or sensitive to any treatments.
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Affiliation(s)
- Jared W Young
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
| | - Christopher V Barback
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Louise A Stolz
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA
| | - Stephanie M Groman
- Department of Neuroscience, Medical Discovery Team on Addiction, University of Minnesota
| | - David R Vera
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Carl Hoh
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Kishore K Kotta
- Department of Radiology, University of California, San Diego, La Jolla California; UCSD In Vivo Cancer and Molecular Imaging Program
| | - Arpi Minassian
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Susan B Powell
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Arthur L Brody
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive MC 0804, La Jolla, CA 92093-0804, USA; Research Service, VA San Diego Healthcare System, San Diego, CA, USA
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Monnig MA, Gullett JM, Porges EC, Woods AJ, Monti PM, Tashima K, Jahanshad N, Thompson P, Nir T, Cohen RA. Associations of alcohol use, HIV infection, and age with brain white matter microstructure. J Neurovirol 2021; 27:936-950. [PMID: 34750783 PMCID: PMC8901452 DOI: 10.1007/s13365-021-01021-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 08/24/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Heavy drinking and HIV infection are independently associated with damage to the brain's white matter. The purpose of the current study was to investigate whether current alcohol consumption, HIV infection, and associated characteristics were associated with indices of white matter microstructural integrity in people living with HIV (PLWH) and seronegative individuals. PLWH and controls were categorized as non-drinkers, moderate drinkers, or heavy drinkers. White matter fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were assessed using diffusion tensor imaging (DTI). Voxelwise analyses using tract-based spatial statistics were followed by confirmatory region-of-interest (ROI) analyses. Data from 108 participants (62 PLWH, 46 controls) were suitable for analysis. Average age (± standard deviation) was 45.2 ± 11.1 years, and the sample was 42% female. The majority of PLWH were on antiretroviral therapy (94%) and were virally suppressed (69%). PLWH and controls did not differ on substance use. Heavier alcohol intake was significantly associated with lower FA and higher RD in widespread areas. Heavy drinking was significantly associated with higher AD in a small region. The main effect of HIV was not significant, but a significant HIV-age interaction was observed. Follow-up ROI analyses confirmed the main effect of drinking group and HIV-age interaction. In conclusion, results are consistent with a dose-dependent association of alcohol use with lower white matter microstructural coherence. Concordance between FA and RD findings suggests dysmyelination as a mechanism. Findings underscore the need to address unhealthy alcohol use in HIV-positive and seronegative individuals, the consequences of which may be exacerbated by aging.
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Affiliation(s)
| | - Joseph M Gullett
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32611, USA
| | - Eric C Porges
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32611, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32611, USA
| | - Peter M Monti
- Brown University, Box G-S121-5, Providence, RI, 02912, USA
| | | | - Neda Jahanshad
- Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Paul Thompson
- Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Talia Nir
- Keck School of Medicine, University of Southern California, Los Angeles, CA, 90033, USA
| | - Ronald A Cohen
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, 32611, USA
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Tatar G, Çermik TF, Alçın G, Erol Fenercioglu O, İnci A, Beyhan E, Ergül N. Contribution of 18F-FDG PET/CT imaging in the diagnosis and management of HIV-positive patients. Rev Esp Med Nucl Imagen Mol 2021; 41:275-283. [PMID: 34794914 DOI: 10.1016/j.remnie.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/06/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES The human immunodeficiency virus [HIV] is a lentevirus, primarily infects certain cells of the immune system, thereby greatly weakens the body's own defenses against diseases. This study was aimed to explore the value and significance of 18F-FDG PET/CT in the assessment of patients with HIV infection and to examine the presence of quantitative alterations in 18F-FDG uptake among patients with HIV-related infections or malignant diseases in HIV-positive patients. PATIENTS AND METHODS Forty patients with HIV infection were scanned on PET/CT system. The data were registered according to immune status, antiretroviral therapy, and definitive diagnosis. All pathologic lesions and disease related areas were described, 18F-FDG uptake patterns were evaluated. Semiquantitative analysis of 18F-FDG uptake was performed and SUVmax were calculated. RESULTS Twenty-eight patients [70%] were diagnosed with HIV-related infection or malignant diseases. The sensitivity of PET/CT was shown to be 100% and the specificity 92% for concomitant diseases requiring additional treatment to antiretroviral therapy. The SUVmax and CD4 counts were not statistically different between HIV-related reactive lymphadenopathy, HIV-related malignancy, and HIV-related infections. CONCLUSIONS The pattern of distribution of nodal/extranodal uptake on 18F-FDG PET/CT may facilitate distinction between HIV-related generalized lymphadenopathies, HIV-related opportunistic infections, and malignancies. In this context, 18F-FDG PET/CT should be preferred for routine use in the management of patients infected with HIV.
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Affiliation(s)
- Gamze Tatar
- University of Health Sciences, Istanbul Bagcılar Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey.
| | - Tevfik Fikret Çermik
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
| | - Göksel Alçın
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
| | - Ozge Erol Fenercioglu
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
| | - Ayşe İnci
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Infectious Disease, Istanbul, Turkey
| | - Ediz Beyhan
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
| | - Nurhan Ergül
- University of Health Sciences, Istanbul Training and Research Hospital, Department of Nuclear Medicine, Istanbul, Turkey
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Dahmani S, Kaliss N, VanMeter JW, Moore DJ, Ellis RJ, Jiang X. Alterations of Brain Metabolites in Adults With HIV: A Systematic Meta-analysis of Magnetic Resonance Spectroscopy Studies. Neurology 2021; 97:e1085-e1096. [PMID: 34253633 PMCID: PMC8456358 DOI: 10.1212/wnl.0000000000012394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 05/20/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE A meta-analysis of proton magnetic resonance spectroscopy studies to investigate alterations in brain metabolites in people with HIV (PWH), the relationship between metabolite alterations and combination antiretroviral therapy (cART), and the relationship between metabolite alterations and cognitive impairment. METHODS The PubMed database was searched for studies published from 1997 to 2020. Twenty-seven studies were identified, which included 1255 PWH and 633 controls. Four metabolites (N-acetyl aspartate [NAA], myo-inositol [mI], choline [Cho], and glutamatergic metabolites [Glx]) from 5 brain regions (basal ganglia [BG], frontal gray and white matter [FGM and FWM], and parietal gray and white matter [PGM and PWM]) were pooled separately using random-effects meta-analysis. RESULTS During early HIV infection, metabolite alterations were largely limited to the BG, including Cho elevation, a marker of inflammation. cART led to global mI and Cho normalization (i.e., less elevations), but improvement in NAA was negligible. In chronic PWH on cART, there were consistent NAA reductions across brain regions, along with Cho and mI elevations in the FWM and BG, and Glx elevations in the FWM. Cognitive impairment was associated with NAA reduction and to a lesser degree mI elevation. CONCLUSIONS The BG are the primary region affected during early infection. cART is successful in partially controlling neuroinflammation (global mI and Cho normalization). However, neuronal dysfunction (NAA reductions) and neuroinflammation (mI and Cho elevations) persist and contribute to cognitive impairment in chronic PWH. Novel compounds targeting NAA signal pathways, along with better neuroinflammation control, may help to reduce cognitive impairment in PWH.
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Affiliation(s)
- Sophia Dahmani
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - Nicholas Kaliss
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - John W VanMeter
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - David J Moore
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - Ronald J Ellis
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla
| | - Xiong Jiang
- From the Department of Neuroscience (S.D., N.K., X.J.) and Department of Neurology (J.W.V.), Georgetown University Medical Center, Washington, DC; Department of Psychiatry (D.J.M., R.J.E.) and Department of Neurosciences (R.J.E.), University of California, San Diego, La Jolla.
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Murray KD, Uddin MN, Tivarus ME, Sahin B, Wang HZ, Singh MV, Qiu X, Wang L, Spincemaille P, Wang Y, Maggirwar SB, Zhong J, Schifitto G. Increased risk for cerebral small vessel disease is associated with quantitative susceptibility mapping in HIV infected and uninfected individuals. Neuroimage Clin 2021; 32:102786. [PMID: 34500428 PMCID: PMC8429957 DOI: 10.1016/j.nicl.2021.102786] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/19/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022]
Abstract
The aim of this study was to assess, in the context of cerebral small vessel disease (CSVD), whether cardiovascular risk factors and white matter hyperintensities (WMHs) were associated with brain tissue susceptibility as measured by quantitative susceptibility mapping (QSM). Given that CSVD is diagnosed by the presence of lacunar strokes, periventricular and deep WMHs, increased perivascular spaces, and microbleeds, we expected that QSM could capture changes in brain tissue due to underlying CSVD pathology. We compared a cohort of 101 HIV-infected individuals (mean age ± SD = 53.2 ± 10.9 years) with mild to moderate cardiovascular risk scores, as measured by the Reynolds risk score, to 102 age-matched controls (mean age (SD) = 50.3 (15.7) years) with similar Reynolds scores. We performed brain MRI to assess CSVD burden by acquiring 3D T1-MPRAGE, 3D FLAIR, 2D T2-TSE, and mGRE for QSM. We found that signs of CSVD are significantly higher in individuals with HIV-infection compared to controls and that WMH volumes are significantly correlated with age and cardiovascular risk scores. Regional QSM was associated with cardiovascular risk factors, age, sex, and WMH volumes but not HIV status. These results suggest that QSM may be an early imaging marker reflective of alterations in brain microcirculation.
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Affiliation(s)
- Kyle D Murray
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, United States
| | - Md Nasir Uddin
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Madalina E Tivarus
- Department of Imaging Sciences, University of Rochester, Rochester, NY, United States; Department of Neuroscience, University of Rochester, Rochester, NY, United States
| | - Bogachan Sahin
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Henry Z Wang
- Department of Imaging Sciences, University of Rochester, Rochester, NY, United States
| | - Meera V Singh
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Xing Qiu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, United States
| | - Lu Wang
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, United States
| | - Pascal Spincemaille
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States
| | - Yi Wang
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, United States; Department of Biomedical Engineering, Cornell University, Ithaca, NY, United States
| | - Sanjay B Maggirwar
- Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, DC, United States
| | - Jianhui Zhong
- Department of Physics and Astronomy, University of Rochester, Rochester, NY, United States; Department of Imaging Sciences, University of Rochester, Rochester, NY, United States; Department of Biomedical Engineering, University of Rochester, Rochester, NY, United States
| | - Giovanni Schifitto
- Department of Neurology, University of Rochester, Rochester, NY, United States; Department of Imaging Sciences, University of Rochester, Rochester, NY, United States; Department of Electrical and Computer Engineering, University of Rochester, Rochester, NY, United States.
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van Biljon N, Robertson F, Holmes M, Cotton MF, Laughton B, van der Kouwe A, Meintjes E, Little F. Multivariate approach for longitudinal analysis of brain metabolite levels from ages 5-11 years in children with perinatal HIV infection. Neuroimage 2021; 237:118101. [PMID: 33961998 PMCID: PMC8295244 DOI: 10.1016/j.neuroimage.2021.118101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/16/2021] [Accepted: 04/19/2021] [Indexed: 12/03/2022] Open
Abstract
Treatment guidelines recommend that children with perinatal HIV infection (PHIV) initiate antiretroviral therapy (ART) early in life and remain on it lifelong. As part of a longitudinal study examining the long-term consequences of PHIV and early ART on the developing brain, 89 PHIV children and a control group of 85 HIV uninfected children (HIV-) received neuroimaging at ages 5, 7, 9 and 11 years, including single voxel magnetic resonance spectroscopy (MRS) in three brain regions, namely the basal ganglia (BG), midfrontal gray matter (MFGM) and peritrigonal white matter (PWM). We analysed age-related changes in absolute metabolite concentrations using a multivariate approach traditionally applied to ecological data, the Correlated Response Model (CRM) and compared these to results obtained from a multilevel mixed effect modelling (MMEM) approach. Both approaches produce similar outcomes in relation to HIV status and age effects on longitudinal trajectories. Both methods found similar age-related increases in both PHIV and HIV- children in almost all metabolites across regions. We found significantly elevated GPC+PCh across regions (95% CI=[0.033; 0.105] in BG; 95% CI=[0.021; 0.099] in PWM; 95% CI=[0.059; 0.137] in MFGM) and elevated mI in MFGM (95% CI=[0.131; 0.407]) among children living with PHIV compared to HIV- children; additionally the CRM model also indicated elevated mI in BG (95% CI=[0.008; 0.248]). These findings suggest persistent inflammation across the brain in young children living with HIV despite early ART initiation.
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Affiliation(s)
- Noëlle van Biljon
- Department of Statistical Sciences, University of Cape Town, Private Bag X3, Rhodes Gift, 7707 Cape Town, South Africa; Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa
| | - Frances Robertson
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa; Cape Universities Body Imaging Centre, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa
| | - Martha Holmes
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa
| | - Mark F Cotton
- FAMCRU, Department of Paediatrics and Child Health and Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa
| | - Barbara Laughton
- FAMCRU, Department of Paediatrics and Child Health and Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa
| | - Andre van der Kouwe
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa; Athinoula A. Martinos Center, Massachusetts General Hospital, Charlestown, MA, United States
| | - Ernesta Meintjes
- Biomedical Engineering Research Centre, Division of Biomedical Engineering, Department of Human Biology, University of Cape Town, South Africa; Cape Universities Body Imaging Centre, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa
| | - Francesca Little
- Department of Statistical Sciences, University of Cape Town, Private Bag X3, Rhodes Gift, 7707 Cape Town, South Africa.
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Fernandez Cruz AL, Chen CM, Sanford R, Collins DL, Brouillette MJ, Mayo NE, Fellows LK. Multimodal neuroimaging markers of variation in cognitive ability in older HIV+ men. PLoS One 2021; 16:e0243670. [PMID: 34314416 PMCID: PMC8315526 DOI: 10.1371/journal.pone.0243670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 07/12/2021] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE This study used converging methods to examine the neural substrates of cognitive ability in middle-aged and older men with well-controlled HIV infection. METHODS Seventy-six HIV+ men on antiretroviral treatment completed an auditory oddball task and an inhibitory control (Simon) task while time-locked high-density EEG was acquired; 66 had usable EEG data from one or both tasks; structural MRI was available for 43. We investigated relationships between task-evoked EEG responses, cognitive ability and immunocompromise. We also explored the structural correlates of these EEG markers in the sub-sample with complete EEG and MRI data (N = 27). RESULTS EEG activity was associated with cognitive ability at later (P300) but not earlier stages of both tasks. Only the oddball task P300 was reliably associated with HIV severity (nadir CD4). Source localization confirmed that the tasks engaged partially distinct circuits. Thalamus volume correlated with oddball task P300 amplitude, while globus pallidus volume was related to the P300 in both tasks. INTERPRETATION This is the first study to use task-evoked EEG to identify neural correlates of individual differences in cognition in men living with well-controlled HIV infection, and to explore the structural basis of the EEG markers. We found that EEG responses evoked by the oddball task are more reliably related to cognitive performance than those evoked by the Simon task. We also provide preliminary evidence for a subcortical contribution to the effects of HIV infection severity on P300 amplitudes. These results suggest brain mechanisms and candidate biomarkers for individual differences in cognition in HIV.
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Affiliation(s)
- Ana Lucia Fernandez Cruz
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Chien-Ming Chen
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ryan Sanford
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - D. Louis Collins
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Nancy E. Mayo
- School of Physical and Occupational Therapy, Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Lesley K. Fellows
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Sakai M, Higashi M, Fujiwara T, Uehira T, Shirasaka T, Nakanishi K, Kashiwagi N, Tanaka H, Terada H, Tomiyama N. MRI imaging features of HIV-related central nervous system diseases: diagnosis by pattern recognition in daily practice. Jpn J Radiol 2021; 39:1023-1038. [PMID: 34125369 PMCID: PMC8202053 DOI: 10.1007/s11604-021-01150-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 06/01/2021] [Indexed: 01/10/2023]
Abstract
With the advent of antiretroviral therapy (ART), the prognosis of people infected with human immunodeficiency virus (HIV) has improved, and the frequency of HIV-related central nervous system (CNS) diseases has decreased. Nevertheless, mortality from HIV-related CNS diseases, including those associated with ART (e.g., immune reconstitution inflammatory syndrome) remains significant. Magnetic resonance imaging (MRI) can improve the outlook for people with HIV through early diagnosis and prompt treatment. For example, HIV encephalopathy shows a diffuse bilateral pattern, whereas progressive multifocal leukoencephalopathy, HIV-related primary CNS lymphoma, and CNS toxoplasmosis show focal patterns on MRI. Among the other diseases caused by opportunistic infections, CNS cryptococcosis and CNS tuberculosis have extremely poor prognoses unless diagnosed early. Immune reconstitution inflammatory syndrome shows distinct MRI findings from the offending opportunistic infections. Although distinguishing between HIV-related CNS diseases based on imaging alone is difficult, in this review, we discuss how pattern recognition approaches can contribute to their early differentiation.
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Affiliation(s)
- Mio Sakai
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka-shi, Osaka, 541-8567, Japan.
| | - Masahiro Higashi
- Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-shi, Osaka, 540-0006, Japan
| | - Takuya Fujiwara
- Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-shi, Osaka, 540-0006, Japan
| | - Tomoko Uehira
- AIDS Medical Center, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-shi, Osaka, 540-0006, Japan
| | - Takuma Shirasaka
- AIDS Medical Center, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-shi, Osaka, 540-0006, Japan
| | - Katsuyuki Nakanishi
- Department of Diagnostic and Interventional Radiology, Osaka International Cancer Institute, 3-1-69, Otemae, Chuo-ku, Osaka-shi, Osaka, 541-8567, Japan
| | - Nobuo Kashiwagi
- Department of Future Diagnostic Radiology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Hisashi Tanaka
- Department of Radiology, Osaka University Graduate School of Medicine, 2‑2, Yamadaoka, Suita, Osaka, 565‑0871, Japan
| | - Hitoshi Terada
- Department of Radiology, Toho University Sakura Medical Center, 564-1, Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, 2‑2, Yamadaoka, Suita, Osaka, 565‑0871, Japan
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Hall SA, Towe SL, Nadeem MT, Hobkirk AL, Hartley BW, Li R, Huettel SA, Meade CS. Hypoactivation in the precuneus and posterior cingulate cortex during ambiguous decision making in individuals with HIV. J Neurovirol 2021; 27:463-475. [PMID: 33983505 PMCID: PMC8276275 DOI: 10.1007/s13365-021-00981-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/25/2022]
Abstract
People with human immunodeficiency virus (HIV) often have neurocognitive impairment. People with HIV make riskier decisions when the outcome probabilities are known, and have abnormal neural architecture underlying risky decision making. However, ambiguous decision making, when the outcome probabilities are unknown, is more common in daily life, but the neural architecture underlying ambiguous decision making in people with HIV is unknown. Eighteen people with HIV and 20 controls completed a decision making task while undergoing functional magnetic resonance imaging scanning. Participants chose between a certain reward and uncertain reward with a known (risky) or unknown (ambiguous) probability of winning. There were three levels of risk: high, medium, and low. Ambiguous > risky brain activity was compared between groups. Ambiguous > risky brain activity was correlated with emotional/psychiatric functioning in people with HIV. Both groups were similarly ambiguity-averse. People with HIV were more risk-averse than controls and chose the high-risk uncertain option less often. People with HIV had hypoactivity in the precuneus, posterior cingulate cortex (PCC), and fusiform gyrus during ambiguous > medium risk decision making. Ambiguous > medium risk brain activity was negatively correlated with emotional/psychiatric functioning in individuals with HIV. To make ambiguous decisions, people with HIV underrecruit key regions of the default mode network, which are thought to integrate internally and externally derived information to come to a decision. These regions and related cognitive processes may be candidates for interventions to improve decision-making outcomes in people with HIV.
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Affiliation(s)
- Shana A Hall
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA.
| | - Sheri L Towe
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - M Tauseef Nadeem
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Andrea L Hobkirk
- Department of Psychiatry and Behavioral Sciences, Pennsylvania State University, 500 University Dr. Hershey, PA, 17033, USA
- Department of Public Health Sciences, Pennsylvania State University, 700 HMC Crescent Rd., Hershey, PA, 17033, USA
| | - Bennett W Hartley
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
| | - Rosa Li
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Campus Box #3270 235 E. Cameron Ave., Chapel Hill, NC, 27599-3270, USA
| | - Scott A Huettel
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Dr. Campus Box 90086, Durham, NC, 27708-0086, USA
| | - Christina S Meade
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27710, USA
- Brain Imaging and Analysis Center, Duke University Medical Center, Campus Box 3918, Durham, NC, 27710, USA
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Cincin A, Ozben B, Tukenmez Tigen E, Sunbul M, Sayar N, Gurel E, Tigen K, Korten V. Ventricular and atrial functions assessed by speckle-tracking echocardiography in patients with human immunodeficiency virus. J Clin Ultrasound 2021; 49:341-350. [PMID: 32954546 DOI: 10.1002/jcu.22921] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/29/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Antiretroviral therapy (ART) has dramatically changed the clinical manifestation of human immunodeficiency virus (HIV) associated cardiomyopathy from severe left ventricular (LV) systolic dysfunction to a pattern of subclinical cardiac dysfunction. The aim of this study was to evaluate by speckle tracking echocardiography (STE) LV, right ventricular (RV), and biatrial functions in HIV-infected patients under different ART combinations. METHODS We consecutively included 128 HIV-infected patients (mean age 44.2 ± 10.1 years, 110 males) and 100 controls (mean age 42.1 ± 9.4 years, 83 males). Ventricular and atrial functions were assessed by both conventional and STE. RESULTS Although there was not any significant difference in conventional echocardiographic variables, HIV-infected patients had significantly lower LV global longitudinal strain (GLS), RV GLS, left atrial (LA) reservoir and conduit strain, and right atrial conduit strain. HIV patients receiving integrase strand transfer inhibitors and protease inhibitors (PI) had significantly lower LV GLS and LA conduit strain, while patients receiving non-nucleoside reverse transcriptase inhibitors and PI had significantly lower RV GLS than controls. CD4 count at the time of echocardiography was strongly correlated with LV GLS (r = .619, P < .001) and RV GLS (r = .606, P < .001). CONCLUSION Biventricular and atrial functions are subclinically impaired in HIV-infected patients. ART regimen may also affect myocardial functions.
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Affiliation(s)
- Altug Cincin
- Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey
| | - Beste Ozben
- Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey
| | - Elif Tukenmez Tigen
- Marmara University School of Medicine Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Murat Sunbul
- Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey
| | - Nurten Sayar
- Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey
| | - Emre Gurel
- Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey
| | - Kursat Tigen
- Marmara University School of Medicine Department of Cardiology, Istanbul, Turkey
| | - Volkan Korten
- Marmara University School of Medicine Department of Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Kato DMP, Lorusso L, Bruns RF, Pinhat EC, Dalla Costa NRA, Pletsch L, Araujo Júnior E. Performance of a local reference curve for predicting small for gestational age fetuses in pregnant women with HIV/AIDS. J Clin Ultrasound 2021; 49:322-327. [PMID: 33615495 DOI: 10.1002/jcu.22961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/06/2020] [Accepted: 11/26/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE To compare the performance of a local estimated fetal weight curve with curves established for other populations to predict small for gestational age (SGA) fetuses. METHODS A retrospective and cross-sectional study involving 231 fetuses in which the performance of a local curve (proposed model) was compared with the Hadlock and Intergrowth-21st curves in the prediction of SGA fetuses, by applying them to a population of high-risk pregnant woman with HIV/AIDS. For each model, a receiver operating characteristic curve was adjusted, considering the SGA classification by the neonatal Intergrowth method as the gold standard, and the area under the curve (AUC) was calculated. RESULTS The models presented linear correlations with each other. The agreement of the proposed model with Hadlock was very good (kappa = 0.83), whereas the proposed model and Intergrowth-21st had moderate agreement (kappa = 0.44). The SGA fetus detection sensitivities of the proposed model and Hadlock were 61.9% and 57.1%, with specificity of 84.1% and 86.2% and accuracy of 80.1% and 81%, respectively, without statistical difference. The sensitivity of the Intergrowth-21st model was 33.3%, while the accuracy was 85.7% and the specificity was 97.4%. The AUC estimated values for the Hadlock, proposed, and Intergrowth-21st models were 0.834, 0.832, and 0.835, respectively. CONCLUSION The proposed model and Hadlock were interchangeable in the prediction of SGA fetuses and superior to the Intergrowth-21st model.
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Affiliation(s)
| | - Liziane Lorusso
- Department of Obstetrics and Gynecology, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Rafael Frederico Bruns
- Department of Obstetrics and Gynecology, Federal University of Paraná (UFPR), Curitiba, Brazil
| | | | | | - Letícia Pletsch
- Department of Obstetrics and Gynecology, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Edward Araujo Júnior
- Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
- Medical Course, Municipal University of São Caetano do Sul (USCS), Bela Vista Campus, São Paulo, Brazil
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Herskovitz J, Hasan M, Machhi J, Mukadam I, Ottemann BM, Hilaire JR, Woldstad C, McMillan J, Liu Y, Seravalli J, Sarella A, Gendelman HE, Kevadiya BD. Europium sulfide nanoprobes predict antiretroviral drug delivery into HIV-1 cell and tissue reservoirs. Nanotheranostics 2021; 5:417-430. [PMID: 33972918 PMCID: PMC8100756 DOI: 10.7150/ntno.59568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Delivery of long-acting nanoformulated antiretroviral drugs (ARVs) to human immunodeficiency virus type one cell and tissue reservoirs underlies next generation antiretroviral therapeutics. Nanotheranostics, comprised of trackable nanoparticle adjuncts, can facilitate ARV delivery through real-time drug tracking made possible through bioimaging platforms. Methods: To model HIV-1 therapeutic delivery, europium sulfide (EuS) nanoprobes were developed, characterized and then deployed to cells, tissues, and rodents. Tests were performed with nanoformulated rilpivirine (NRPV), a non-nucleoside reverse transcriptase inhibitor (NNRTI) used clinically to suppress or prevent HIV-1 infection. First, CD4+ T cells and monocyte-derived macrophages were EuS-treated with and without endocytic blockers to identify nanoprobe uptake into cells. Second, Balb/c mice were co-dosed with NRPV and EuS or lutetium177-doped EuS (177LuEuS) theranostic nanoparticles to assess NRPV biodistribution via mass spectrometry. Third, single photon emission computed tomography (SPECT-CT) and magnetic resonance imaging (MRI) bioimaging were used to determine nanotheranostic and NRPV anatomic redistribution over time. Results: EuS nanoprobes and NRPV entered cells through dynamin-dependent pathways. SPECT-CT and MRI identified biodistribution patterns within the reticuloendothelial system for EuS that was coordinate with NRPV trafficking. Conclusions: EuS nanoprobes parallel the uptake and biodistribution of NRPV. These data support their use in modeling NRPV delivery to improve treatment strategies.
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Affiliation(s)
- Jonathan Herskovitz
- Department of Pathology and Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Mahmudul Hasan
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198 USA
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Jatin Machhi
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Insiya Mukadam
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Brendan M. Ottemann
- Department of Otorhinolaryngology, University of Kansas Medical Center, Kansas City, KS 66213 USA
| | - James R. Hilaire
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | | | - JoEllyn McMillan
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Yutong Liu
- Department of Radiology, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Javier Seravalli
- Department of Biochemistry, University of Nebraska Lincoln, Lincoln, NE 68588 USA
| | - Anandakumar Sarella
- Nebraska Center for Materials and Nanoscience, University of Nebraska Lincoln, Lincoln, NE 68588 USA
| | - Howard E. Gendelman
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198 USA
- Department of Pharmaceutical Sciences, University of Nebraska Medical Center, Omaha, NE 68198 USA
| | - Bhavesh D. Kevadiya
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198 USA
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Zhao J, Ma Z, Chen F, Li L, Ren M, Li A, Jing B, Li H. Human immune deficiency virus-related structural alterations in the brain are dependent on age. Hum Brain Mapp 2021; 42:3131-3140. [PMID: 33755269 PMCID: PMC8193536 DOI: 10.1002/hbm.25423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 12/27/2022] Open
Abstract
Currently, it is still unknown whether human immune deficiency virus (HIV)‐related structural alterations in the brain are dependent on age. With people living with HIV at different ages, we aim to investigate age‐specific structural alterations in HIV patients. Eighty‐three male HIV patients and eighty‐three age‐matched male controls were enrolled, and high‐resolution T1 weighted images were collected and analyzed with four morphological metrics. Then, statistical analyses were respectively conducted to ascertain HIV effects, age effects, and medication effects in brain structure of HIV patients, and the relationship with neuropsychological evaluations were further explored. Finally, discriminative performances of these structural abnormalities were quantitatively testified with three machine learning models. Compared with healthy controls, HIV patients displayed lower gray matter volumes (GMV), lower gyrification index, deeper sulcus depth, and larger cortical thickness (CTH). Age‐specific differences were found in GMV and CTH: young‐aged HIV patients displayed more obvious morphological alterations than middle‐aged HIV patients when comparing corresponding age‐matched healthy controls. Furthermore, age‐specific long‐term medication effect of combination antiretroviral therapy were also presented. Additionally, several subcortical structural changes were negatively associated with language, attention and motor functions. Finally, three machine learning models demonstrated young‐aged HIV patients were easier to be recognized than middle‐aged HIV patients. Our study indicated young‐aged HIV patients were more vulnerable to HIV infection in brain structure than middle‐aged patients, and future studies should not ignore the age effect in studying the HIV‐related abnormalities.
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Affiliation(s)
- Jing Zhao
- School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Zhe Ma
- Department of RadiologyHenan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhouHenanChina
- School of Biomedical EngineeringCapital Medical UniversityBeijingChina
| | - Feng Chen
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Li Li
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Meiji Ren
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Aixin Li
- Center for Infectious DiseasesBeijing Youan Hospital, Capital Medical UniversityBeijingChina
| | - Bin Jing
- School of Biomedical EngineeringCapital Medical UniversityBeijingChina
| | - Hongjun Li
- School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina
- Department of RadiologyBeijing Youan Hospital, Capital Medical UniversityBeijingChina
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McMahon JH, Zerbato JM, Lau JSY, Lange JL, Roche M, Tumpach C, Dantanarayana A, Rhodes A, Chang J, Rasmussen TA, Mackenzie CA, Alt K, Hagenauer M, Roney J, O'Bryan J, Carey A, McIntyre R, Beech P, O'Keefe GJ, Wichmann CW, Scott FE, Guo N, Lee ST, Liu Z, Caskey M, Nussenzweig MC, Donnelly PS, Egan G, Hagemeyer CE, Scott AM, Lewin SR. A clinical trial of non-invasive imaging with an anti-HIV antibody labelled with copper-64 in people living with HIV and uninfected controls. EBioMedicine 2021; 65:103252. [PMID: 33640794 PMCID: PMC7921458 DOI: 10.1016/j.ebiom.2021.103252] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 01/21/2021] [Accepted: 02/04/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND A research priority in finding a cure for HIV is to establish methods to accurately locate and quantify where and how HIV persists in people living with HIV (PLWH) receiving suppressive antiretroviral therapy (ART). Infusing copper-64 (64Cu) radiolabelled broadly neutralising antibodies targeting HIV envelope (Env) with CT scan and positron emission tomography (PET) identified HIV Env in tissues in SIV infected non-human primates . We aimed to determine if a similar approach was effective in people living with HIV (PLWH). METHODS Unmodified 3BNC117 was compared with 3BNC117 bound to the chelator MeCOSar and 64Cu (64Cu-3BNC117) in vitro to assess binding and neutralization. In a clinical trial 64Cu-3BNC117 was infused into HIV uninfected (Group 1), HIV infected and viremic (viral load, VL >1000 c/mL; Group 2) and HIV infected aviremic (VL <20 c/mL; Group 3) participants using two dosing strategies: high protein (3mg/kg unlabeled 3BNC117 combined with <5mg 64Cu-3BNC117) and trace (<5mg 64Cu-3BNC117 only). All participants were screened for 3BNC117 sensitivity from virus obtained from viral outgrowth. Magnetic resonance imaging (MRI)/PET and pharmacokinetic assessments (ELISA for serum 3BNC117 concentrations and gamma counting for 64Cu) were performed 1, 24- and 48-hours post dosing. The trial (clincialtrials.gov NCT03063788) primary endpoint was comparison of PET standard uptake values (SUVs) in regions of interest (e.g lymph node groups and gastrointestinal tract). FINDINGS Comparison of unmodified and modified 3BNC117 in vitro demonstrated no difference in HIV binding or neutralisation. 17 individuals were enrolled of which 12 were dosed including Group 1 (n=4, 2 high protein, 2 trace dose), Group 2 (n=6, 2 high protein, 4 trace) and Group 3 (n=2, trace only). HIV+ participants had a mean CD4 of 574 cells/microL and mean age 43 years. There were no drug related adverse effects and no differences in tissue uptake in regions of interest (e.g lymph node gut, pharynx) between the 3 groups. In the high protein dosing group, serum concentrations of 3BNC117 and gamma counts were highly correlated demonstrating that 64Cu-3BNC117 remained intact in vivo. INTERPRETATION In PLWH on or off ART, the intervention of infusing 64Cu-3BNC117 and MRI/PET imaging over 48 hours, was unable to detect HIV-1 env expression in vivo. Future studies should investigate alternative radiolabels such as zirconium which have a longer half-life in vivo. FUNDING Funded by the Alfred Foundation, The Australian Centre for HIV and Hepatitis Virology Research with additional support from the Division of AIDS, National Institute of Allergy and Infectious Disease, US National Institutes of Health (USAI126611). JHM and SRL are supported by the Australian National Health and Medical Research Council.
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Affiliation(s)
- James H McMahon
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia; Department of Infectious Diseases, Monash Health, Melbourne, Australia
| | - Jennifer M Zerbato
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Jillian S Y Lau
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
| | - Jaclyn L Lange
- Australian Centre for Blood Diseases, Monash University, Melbourne, Australia
| | - Michael Roche
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Carolin Tumpach
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Ashanti Dantanarayana
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Ajantha Rhodes
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Judy Chang
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Thomas A Rasmussen
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Charlene A Mackenzie
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
| | - Karen Alt
- Australian Centre for Blood Diseases, Monash University, Melbourne, Australia
| | - Michelle Hagenauer
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
| | - Janine Roney
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia
| | - Jessica O'Bryan
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia; Department of Infectious Diseases, Monash Health, Melbourne, Australia
| | - Alexandra Carey
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Richard McIntyre
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Paul Beech
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Graeme J O'Keefe
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Australia; Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Christian W Wichmann
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Australia; Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Fiona E Scott
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Australia; Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Nancy Guo
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Sze-Ting Lee
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Australia; Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Zhanqi Liu
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Australia; Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Marina Caskey
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY, United States
| | - Michel C Nussenzweig
- Laboratory of Molecular Immunology, The Rockefeller University, New York, NY, United States; Howard Hughes Medical Institute, The Rockefeller University, New York, NY, United States
| | - Paul S Donnelly
- School of Chemistry, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Melbourne, Australia
| | - Gary Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | | | - Andrew M Scott
- Department of Molecular Imaging and Therapy, Austin Health, and University of Melbourne, Melbourne, Australia; Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, School of Cancer Medicine, La Trobe University, Melbourne, Australia
| | - Sharon R Lewin
- Department of Infectious Diseases, Alfred Hospital and Monash University, Melbourne, Australia; The Peter Doherty Institute for Infection and Immunity, University of Melbourne and Royal Melbourne Hospital, Melbourne, Australia
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Roozen GVT, Meel R, Peper J, Venter WDF, Barth RE, Grobbee DE, Klipstein-Grobusch K, Vos AG. Electrocardiographic and echocardiographic abnormalities in urban African people living with HIV in South Africa. PLoS One 2021; 16:e0244742. [PMID: 33529208 PMCID: PMC7853516 DOI: 10.1371/journal.pone.0244742] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Studies from high income countries report that HIV-positive people have an impaired systolic and diastolic cardiac function compared to HIV-negative people. It is unclear if results can be translated directly to the Sub-Saharan Africa context. This study assesses electro- and echocardiographic characteristics in an urban African population, comparing HIV-positive people (treated and not yet treated) with HIV-negative controls. METHODS We conducted a cross-sectional study in Johannesburg, South Africa. We enrolled HIV-positive participants from three randomized controlled trials that had recruited participants from routine HIV testing programs. HIV-negative controls were recruited from the community. Data were collected on demographics, cardiovascular risk factors, medical history and electrocardiographic and echocardiographic characteristics. RESULTS In total, 394 HIV-positive participants and 153 controls were enrolled. The mean age of HIV-positive participants was 40±9 years (controls: 35±10 years), and 34% were male (controls: 50%). Of HIV-positive participants 36% were overweight or obese (controls: 44%), 23% had hypertension (controls: 28%) and 12% were current smoker (controls: 37%). Median time since HIV diagnosis was 6.0 years (IQR 2.3-10.0) and median treatment duration was 4.0 years (IQR 0.0-8.0), 50% had undetectable viral load. The frequency of anatomical cardiac abnormalities was low and did not differ between people with and without HIV. We observed no relation between HIV or anti-retroviral therapy (ART) and systolic or diastolic heart function. There was an association between ART use and corrected QT interval: +11.8 ms compared to HIV-negative controls (p<0.01) and +18.9 ms compared to ART-naïve participants (p = 0.01). We also observed a higher left ventricular mass index in participants on ART (+7.8 g/m2, p<0.01), but this association disappeared after adjusting for CD4 cell count, viral load and HIV-duration. CONCLUSION The low number of major cardiac abnormalities in this relatively young, well managed urban African HIV-positive population is reassuring. The increase in corrected QT interval and left ventricular mass may contribute to higher cardiac mortality and morbidity in people living with HIV in the long term.
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Affiliation(s)
- Geert V. T. Roozen
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ruchika Meel
- Division of Cardiology, Department of Internal Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Joyce Peper
- Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - William D. F. Venter
- Ezintsha, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Roos E. Barth
- Department of Infectious Disease, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Diederick E. Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alinda G. Vos
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Ezintsha, Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
- * E-mail:
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Elec FI, Moisoiu T, Socaciu MA, Elec AD, Muntean AM, Iacob G, Badea RI. Difficulties in diagnosing HIV-associated nephropathy in kidney transplanted patients. The role of ultrasound and CEUS. Med Ultrason 2020; 22:488-491. [PMID: 32190861 DOI: 10.11152/mu-2314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 62-year-old woman who underwent kidney transplantation in 2014 was diagnosed with HIV infection in 2018. Grey scale and Doppler ultrasound evaluation revealed a normal aspect of the allograft. Contrast-enhanced ultrasound detected a quick cortical contrast uptake followed by a rapid cortical wash-out. This behavior was interpreted as a sign of inflammation. Ten months after ultrasound evaluation the graft presented severe disfunction and the patient was reintroduced into the hemodialysis program.
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Affiliation(s)
- Florin Ioan Elec
- Urology Dept., Clinical Institute of Urology and Renal Transplantation Cluj-Napoca.
| | - Tudor Moisoiu
- Urology Department,Clinical Institute of Urology and Renal Transplantation Cluj-Napoca.
| | - Mihai Adrian Socaciu
- Ultrasound Department, Institute of Gastroenterology and Hepatology "Octavian Fodor", Cluj Napoca..
| | - Alina Daciana Elec
- Nephrology Dept., Clinical Institute of Urology and Renal Transplantation Cluj-Napoca.
| | | | - Gheorghiță Iacob
- Morphology Dept., Clinical Institute of Urology and Renal Transplantation Cluj-Napoca.
| | - Radu Ion Badea
- Ultrasound Department, Institute of Gastroenterology and Hepatology "Octavian Fodor", Cluj Napoca..
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van Genderen JG, Van den Hof M, Boyd AC, Caan MWA, Wit FWNM, Reiss P, Pajkrt D. Differences in location of cerebral white matter hyperintensities in children and adults living with a treated HIV infection: A retrospective cohort comparison. PLoS One 2020; 15:e0241438. [PMID: 33112914 PMCID: PMC7592958 DOI: 10.1371/journal.pone.0241438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022] Open
Abstract
Cerebral white matter hyperintensities (WMH) persist in children and adults living with HIV, despite effective combination antiretroviral therapy (cART). As age and principal routes of transmission differ between children (perinatally) and adults (behaviorally), comparing the characteristics and determinants of WMH between these populations may increase our understanding of the pathophysiology of WMH. From separate cohorts of 31 children (NOVICE) and 74 adults (AGEhIV), we cross-sectionally assessed total WMH volume and number of WMH per location (periventricular vs. deep) using fluid-attenuated inversion recovery (FLAIR) MRI images. WMH were either periventricular when within 10mm of the lateral ventricles, or deep otherwise. We assessed patient- or HIV-related determinants of total WMH volume (adjusted for intracranial volume) and location of WMH using logistic regression, while stratifying on children and adults. At enrollment, median age of participants was 13.8 years (IQR 11.4-15.9) for children and 53.4 years (IQR 48.3-60.8) for adults and 27/31 children (87%) and 74/74 adults (100%) had an HIV RNA viral load <200 copies/mL. WMH were present in 16/27 (52%) children and 74/74 adults (100%). The prevalence of deep WMH was not different between groups, (16/16 [100%] in children vs. 71/74 [96%] in adults, p = 0,999), yet periventricular WMH were more prevalent in adults (74/74 [100%]) compared to children (9/16; 56%) (p<0.001). Median WMH volume was higher in adults compared to children (1182 mm3 [425-2617] vs. 109 mm3 [61.7-625], p<0.001). In children, boys were more likely to have deep WMH compared to girls. In adults, older age was associated with higher total WMH volume, and age, hypertension and lower CD4+ T-lymphocyte nadir with a higher number of periventricular WMH. Our findings suggest that the location of WMH differs between children and adults living with HIV, hinting at a different underlying pathogenesis.
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Affiliation(s)
- Jason G. van Genderen
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital,
Amsterdam UMC, University of Amsterdam, Amsterdam, The
Netherlands
| | - Malon Van den Hof
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital,
Amsterdam UMC, University of Amsterdam, Amsterdam, The
Netherlands
| | - Anders C. Boyd
- HIV Monitoring Foundation, Amsterdam, The Netherlands
- Public Health Service of Amsterdam, Department of Infectious Diseases,
Amsterdam, The Netherlands
| | - Matthan W. A. Caan
- Department of Biomedical Engineering and Physics, Amsterdam UMC,
University of Amsterdam, Amsterdam, The Netherlands
- Department of Radiology, Amsterdam UMC, University of Amsterdam,
Amsterdam, The Netherlands
| | - Ferdinand W. N. M. Wit
- HIV Monitoring Foundation, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam,
The Netherlands
- Department of Global Health, Amsterdam UMC, University of Amsterdam,
Amsterdam, The Netherlands
| | - Peter Reiss
- HIV Monitoring Foundation, Amsterdam, The Netherlands
- Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam,
The Netherlands
- Department of Global Health, Amsterdam UMC, University of Amsterdam,
Amsterdam, The Netherlands
| | - Dasja Pajkrt
- Department of Pediatric Infectious Diseases, Emma Children’s Hospital,
Amsterdam UMC, University of Amsterdam, Amsterdam, The
Netherlands
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44
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Chang L, Liang H, Kandel SR, He JJ. Independent and Combined Effects of Nicotine or Chronic Tobacco Smoking and HIV on the Brain: A Review of Preclinical and Clinical Studies. J Neuroimmune Pharmacol 2020; 15:658-693. [PMID: 33108618 DOI: 10.1007/s11481-020-09963-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 02/07/2023]
Abstract
Tobacco smoking is highly prevalent among HIV-infected individuals. Chronic smokers with HIV showed greater cognitive deficits and impulsivity, and had more psychopathological symptoms and greater neuroinflammation than HIV non-smokers or smokers without HIV infection. However, preclinical studies that evaluated the combined effects of HIV-infection and tobacco smoking are scare. The preclinical models typically used cell cultures or animal models that involved specific HIV viral proteins or the administration of nicotine to rodents. These preclinical models consistently demonstrated that nicotine had neuroprotective and anti-inflammatory effects, leading to cognitive enhancement. Although the major addictive ingredient in tobacco smoking is nicotine, chronic smoking does not lead to improved cognitive function in humans. Therefore, preclinical studies designed to unravel the interactive effects of chronic tobacco smoking and HIV infection are needed. In this review, we summarized the preclinical studies that demonstrated the neuroprotective effects of nicotine, the neurotoxic effects of the HIV viral proteins, and the scant literature on nicotine or tobacco smoke in HIV transgenic rat models. We also reviewed the clinical studies that evaluated the neurotoxic effects of tobacco smoking, HIV infection and their combined effects on the brain, including studies that evaluated the cognitive and behavioral assessments, as well as neuroimaging measures. Lastly, we compared the different approaches between preclinical and clinical studies, identified some gaps and proposed some future directions. Graphical abstract Independent and combined effects of HIV and tobacco/nicotine. Left top and bottom panels: Both clinical studies of HIV infected persons and preclinical studies using viral proteins in vitro or in vivo in animal models showed that HIV infection could lead to neurotoxicity and neuroinflammation. Right top and bottom panels: While clinical studies of tobacco smoking consistently showed deleterious effects of smoking, clinical and preclinical studies that used nicotine show mild cognitive enhancement, neuroprotective and possibly anti-inflammatory effects. In the developing brain, however, nicotine is neurotoxic. Middle overlapping panels: Clinical studies of persons with HIV who were smokers typically showed additive deleterious effects of HIV and tobacco smoking. However, in the preclinical studies, when nicotine was administered to the HIV-1 Tg rats, the neurotoxic effects of HIV were attenuated, but tobacco smoke worsened the inflammatory cascade.
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Affiliation(s)
- Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA.
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
| | - Huajun Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD, 21201, USA
| | - Suresh R Kandel
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA
| | - Johnny J He
- Department of Microbiology and Immunology, Chicago Medical School, Center for Cancer Cell Biology, Immunology and Infection, Rosalind Franklin University, 3333 Green Bay Road, Basic Science Building 2.300, North Chicago, IL, 60064, USA.
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45
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Wang HA, Liang HJ, Ernst TM, Oishi K, Chang L. Microstructural brain abnormalities in HIV+ individuals with or without chronic marijuana use. J Neuroinflammation 2020; 17:230. [PMID: 32758262 PMCID: PMC7409464 DOI: 10.1186/s12974-020-01910-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Cognitive deficits and microstructural brain abnormalities are well documented in HIV-positive individuals (HIV+). This study evaluated whether chronic marijuana (MJ) use contributes to additional cognitive deficits or brain microstructural abnormalities that may reflect neuroinflammation or neuronal injury in HIV+. METHOD Using a 2 × 2 design, 44 HIV+ participants [23 minimal/no MJ users (HIV+), 21 chronic active MJ users (HIV + MJ)] were compared to 46 seronegative participants [24 minimal/no MJ users (SN) and 22 chronic MJ users (SN + MJ)] on neuropsychological performance (7 cognitive domains) and diffusion tensor imaging metrics, using an automated atlas to assess fractional anisotropy (FA), axial (AD), radial (RD), and mean (MD) diffusivities, in 18 cortical and 4 subcortical brain regions. RESULTS Compared to SN and regardless of MJ use, the HIV+ group had lower FA and higher diffusivities in multiple white matter and subcortical structures (p < 0.001-0.050), as well as poorer cognition in Fluency (p = 0.039), Attention/Working Memory (p = 0.009), Learning (p = 0.014), and Memory (p = 0.028). Regardless of HIV serostatus, MJ users had lower AD in uncinate fasciculus (p = 0.024) but similar cognition as nonusers. HIV serostatus and MJ use showed an interactive effect on mean diffusivity in the right globus pallidus but not on cognitive function. Furthermore, lower FA in left anterior internal capsule predicted poorer Fluency across all participants and worse Attention/Working Memory in all except SN subjects, while higher diffusivities in several white matter tracts also predicted lower cognitive domain Z-scores. Lastly, MJ users with or without HIV infection showed greater than normal age-dependent FA declines in superior longitudinal fasciculus, external capsule, and globus pallidus. CONCLUSIONS Our findings suggest that, except in the globus pallidus, chronic MJ use had no additional negative influence on brain microstructure or neurocognitive deficits in HIV+ individuals. However, lower AD in the uncinate fasciculus of MJ users suggests axonal loss in this white matter tract that connects to cannabinoid receptor rich brain regions that are involved in verbal memory and emotion. Furthermore, the greater than normal age-dependent FA declines in the white matter tracts and globus pallidus in MJ users suggest that older chronic MJ users may eventually have lesser neuronal integrity in these brain regions.
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Affiliation(s)
- Hannah A. Wang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD 21201 USA
| | - Hua-Jun Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD 21201 USA
| | - Thomas M. Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD 21201 USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Department of Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, 670 W. Baltimore Street, HSF III, Baltimore, MD 21201 USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD USA
- Department of Medicine, University of Hawaii, John A. Burns School of Medicine, Honolulu, HI USA
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD USA
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46
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Bell RP, Towe SL, Lalee Z, Huettel SA, Meade CS. Neural sensitivity to risk in adults with co-occurring HIV infection and cocaine use disorder. Cogn Affect Behav Neurosci 2020; 20:859-872. [PMID: 32648056 PMCID: PMC7773226 DOI: 10.3758/s13415-020-00806-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Persons with co-occurring HIV infection and cocaine use disorder tend to engage in riskier decision-making. However, the neural correlates of sensitivity to risk are not well-characterized in this population. The purpose of this study was to examine the neural interaction effects of HIV infection and cocaine use disorder to sensitivity to risk. The sample included 79 adults who differed on HIV status and cocaine use disorder. During functional magnetic resonance imaging (fMRI), participants completed a Wheel of Fortune (WoF) task that assessed neural activation in response to variations of monetary risk (i.e., lower probability of winning a larger reward). Across groups, neural activation to increasing risk was in cortical and subcortical regions similar to previous investigations using the WoF in nondrug-using populations. Our analyses showed that there was a synergistic effect between HIV infection and cocaine use in the left precuneus/posterior cingulate cortex and hippocampus, and right postcentral gyrus, lateral occipital cortex, cerebellum, and posterior parietal cortex. HIV+ individuals with cocaine use disorder displayed neural hyperactivation to increasing risk that was not observed in the other groups. These results support a synergistic effect of co-occurring HIV infection and cocaine dependence in neural processing of risk probability that may reflect compensation. Future studies can further investigate and validate how neural activation to increasing risk is associated with risk-taking behavior.
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Affiliation(s)
- Ryan P Bell
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA
| | - Sheri L Towe
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA
| | - Zahra Lalee
- Duke University Department of Psychology and Neuroscience, Durham, NC, 27708, USA
| | - Scott A Huettel
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27708, USA
- Duke University Department of Psychology and Neuroscience, Durham, NC, 27708, USA
| | - Christina S Meade
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Box 102848, Durham, NC, 27708, USA.
- Brain Imaging and Analysis Center, Duke University Medical Center, Durham, NC, 27708, USA.
- Duke University Department of Psychology and Neuroscience, Durham, NC, 27708, USA.
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47
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Mainardi I, Ferrò MT, Gastaldi M, Franciotta D, Cinque P. Acquisition of human immunodeficiency virus infection in a patient with multiple sclerosis: could these conditions positively influence each other's course? J Neurovirol 2020; 26:957-960. [PMID: 32671809 DOI: 10.1007/s13365-020-00876-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
Patients with human immunodeficiency virus (HIV) infection have a decreased risk of developing multiple sclerosis (MS) and MS patients very rarely contract HIV infection. We report on a 35-year-old woman with relapsing-remitting MS, who acquired HIV infection 8 years after MS onset. During 7 years of follow-up without combined antiretroviral therapy (cART), CD4+ counts decreased and HIV viremia increased progressively, but slightly. These trends reverted after starting cART, with optimal viro-immunological control. While the patient had many MS relapses before acquiring HIV infection, she had then only one relapse, shortly after HIV infection, despite irregular or no MS therapy. This case contributes to the discussion about MS and HIV potential interactions and describes for the first time the effects of the MS-targeting drug natalizumab in an HIV-positive patient.
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Affiliation(s)
- Ilaria Mainardi
- Department of Infectious Diseases, San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127, Milan, Italy.
| | | | - Matteo Gastaldi
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - Diego Franciotta
- Neuroimmunology Laboratory, IRCCS Mondino Foundation, Pavia, Italy
| | - Paola Cinque
- Department of Infectious Diseases, San Raffaele Scientific Institute, via Stamira d'Ancona 20, 20127, Milan, Italy
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48
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Adeli E, Li X, Kwon D, Zhang Y, Pohl KM. Logistic Regression Confined by Cardinality-Constrained Sample and Feature Selection. IEEE Trans Pattern Anal Mach Intell 2020; 42:1713-1728. [PMID: 30835210 PMCID: PMC7331794 DOI: 10.1109/tpami.2019.2901688] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Many vision-based applications rely on logistic regression for embedding classification within a probabilistic context, such as recognition in images and videos or identifying disease-specific image phenotypes from neuroimages. Logistic regression, however, often performs poorly when trained on data that is noisy, has irrelevant features, or when the samples are distributed across the classes in an imbalanced setting; a common occurrence in visual recognition tasks. To deal with those issues, researchers generally rely on ad-hoc regularization techniques or model a subset of these issues. We instead propose a mathematically sound logistic regression model that selects a subset of (relevant) features and (informative and balanced) set of samples during the training process. The model does so by applying cardinality constraints (via l0-'norm' sparsity) on the features and samples. l0 defines sparsity in mathematical settings but in practice has mostly been approximated (e.g., via l1 or its variations) for computational simplicity. We prove that a local minimum to the non-convex optimization problems induced by cardinality constraints can be computed by combining block coordinate descent with penalty decomposition. On synthetic, image recognition, and neuroimaging datasets, we show that the accuracy of the method is higher than alternative methods and classifiers commonly used in the literature.
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Affiliation(s)
| | | | - Dongjin Kwon
- Center for Health Sciences, SRI International, Menlo Park, CA, 94025
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305
| | - Yong Zhang
- Vancouver Research Center, Huawei, Burnaby, BC, Canada V5C 6S7
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49
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Popov M, Molsberry SA, Lecci F, Junker B, Kingsley LA, Levine A, Martin E, Miller E, Munro CA, Ragin A, Seaberg E, Sacktor N, Becker JT. Brain structural correlates of trajectories to cognitive impairment in men with and without HIV disease. Brain Imaging Behav 2020; 14:821-829. [PMID: 30623289 PMCID: PMC6616021 DOI: 10.1007/s11682-018-0026-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There are distinct trajectories to cognitive impairment among participants in the Multicenter AIDS Cohort Study (MACS). Here we analyzed the relationship between regional brain volumes and the individual trajectories to impairment in a subsample (n = 302) of the cohort. 302 (167 HIV-infected; mean age = 55.7 yrs.; mean education: 16.2 yrs.) of the men enrolled in the MACS MRI study contributed data to this analysis. We used voxel-based morphometry (VBM) to segment the brain images to analyze gray and white matter volume at the voxel-level. A Mixed Membership Trajectory Model had previously identified three distinct profiles, and each study participant had a membership weight for each of these three trajectories. We estimated VBM model parameters for 100 imputations, manually performed the post-hoc contrasts, and pooled the results. We examined the associations between brain volume at the voxel level and the MMTM membership weights for two profiles: one considered "unhealthy" and the other considered "Premature aging." The unhealthy profile was linked to the volume of the posterior cingulate gyrus/precuneus, the inferior frontal cortex, and the insula, whereas the premature aging profile was independently associated with the integrity of a portion of the precuneus. Trajectories to cognitive impairment are the result, in part, of atrophy in cortical regions linked to normal and pathological aging. These data suggest the possibility of predicting cognitive morbidity based on patterns of CNS atrophy.
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Affiliation(s)
- Mikhail Popov
- Department of Psychiatry, University of Pittsburgh, Suite 830, 3501 Forbes Avenue, Pittsburgh, PA, 15213, USA
- Wikimedia Foundation, San Francisco, CA, USA
| | - Samantha A Molsberry
- Department of Psychiatry, University of Pittsburgh, Suite 830, 3501 Forbes Avenue, Pittsburgh, PA, 15213, USA
- Population Health Sciences, Harvard University, Cambridge, MA, USA
| | - Fabrizio Lecci
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA
- Uber, New York, NY, USA
| | - Brian Junker
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA, USA
| | - Lawrence A Kingsley
- Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew Levine
- Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA
| | - Eileen Martin
- Department of Psychiatry, Rush Medical School, Chicago, IL, USA
| | - Eric Miller
- Department of Psychiatry, University of California Los Angeles, Los Angeles, CA, USA
| | - Cynthia A Munro
- Department of Psychiatry, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ann Ragin
- Department of Radiology, Northwestern University, Evanston, IL, USA
| | - Eric Seaberg
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ned Sacktor
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James T Becker
- Department of Psychiatry, University of Pittsburgh, Suite 830, 3501 Forbes Avenue, Pittsburgh, PA, 15213, USA.
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.
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50
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Aljizeeri A, Small G, Malhotra S, Buechel R, Jain D, Dwivedi G, Al-Mallah MH. The role of cardiac imaging in the management of non-ischemic cardiovascular diseases in human immunodeficiency virus infection. J Nucl Cardiol 2020; 27:801-818. [PMID: 30864047 DOI: 10.1007/s12350-019-01676-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 10/27/2022]
Abstract
Infection with human immunodeficiency virus (HIV) has become the pandemic of the new century. About 36.9 million people are living with HIV worldwide. The introduction of antiretroviral therapy in 1996 has dramatically changed the global landscape of HIV care, resulting in significantly improved survival and changing HIV to a chronic disease. With near-normal life expectancy, contemporary cardiac care faces multiple challenges of cardiovascular diseases, disorders specific to HIV/AIDS, and those related to aging and higher prevalence of traditional risk factors. Non-ischemic cardiovascular diseases are major components of cardiovascular morbidity and mortality in HIV/AIDS. Non-invasive cardiac imaging plays a pivotal role in the management of these diseases. This review summarizes the non-ischemic presentation of the HIV cardiovascular spectrum focusing on the role of cardiac imaging in the management of these disorders.
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Affiliation(s)
- Ahmed Aljizeeri
- King Abdulaziz Cardiac Center, Ministry of National Guard-Health Affaire, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Gary Small
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Saurabh Malhotra
- Division of Cardiology, Cook County Health, Chicago, IL, USA
- Division of Cardiology, Rush Medical College, Chicago, IL, USA
| | - Ronny Buechel
- Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland
| | - Diwakar Jain
- Division of Cardiology and Nuclear Medicine, New York Medical College/Westchester Medical Center, Hawthorne, NY, USA
| | - Girish Dwivedi
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Harry Perkins Institute of Medical Research, Murdoch, WA, Australia
- The University of Western Australia, Crawley, WA, Australia
| | - Mouaz H Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, 6565 Fannin Street, Smith-19, Houston, TX, 77030, USA.
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