Progressive brain atrophy in treated HIV positive individuals
In a longitudinal neuroimaging study “tensor-based morphometry”
was used to estimate the annual rate of change of
regional brain volume in HIV infected individuals. 155 individuals
with a mean age of 48 years participated in the study.
Between 2003 and 2009 TI-weighed MRI and neuropsychological
data were collected at two time points with a mean time
interval of 1 +/- 0.5 years. All participants were on stable antiretroviral
therapy although 24.8 % had viral load > 400 copies/
mL. There was no HIV-negative control group in the study.
Instead controls were obtained from a previously published
study comparing healthy controls to individuals with
Parkinson´s disease. The control group was not matched for age, sex,
or education. In summary, significant loss of brain tissue was
found, including in neuro-asymptomatic individuals with undetectable
viral load. Disease severity, neurocognitive decline,
and age were associated with greater atrophy.
Ref; Nir et al. J Neurovirol. 2019 Feb 14. doi: 10.1007/s13365-019-00723-4
Comment: Without a properly matched control group it is difficult
to draw any definite conclusions. The fact that one quarter
of the participants did not have suppressed viremia may
also be of importance in interpreting the results of the study.