Abstract Details

Title Effects of Primary and Chronic HIV Infection on White Matter Integrity Using Diffusion Tensor Imaging

Topic Infections/AIDS/Prion Disease

Presentation(s) P06 - (-)

Poster/Presentation
Number 175

Objective

Background BACKGROUND: HIV enters the brain soon after seroconversion. Chronic HIV infection (CHI) preferentially damages white matter (WM) in the brain, but it remains unknown if WM is affected in primary HIV infection (PHI).

Design/Methods DESIGN/METHODS: Cerebrospinal fluid (CSF), blood, neuropsychological (NP) testing, and DTI were acquired in 97 participants (19 HIV- controls, 62 PHI, 16 CHI). Region of interest (ROI) analysis was performed on calculated DTI measures (fractional anisotropy (FA), mean diffusivity (MD)) from five CC subregions. Voxelwise statistical analysis of FA and MD skeletons was performed using Tract-Based Spatial Statistics (TBSS). Student's t-test and Pearson correlation were used to compare DTI metrics among WM regions and to lab values.

Results RESULTS: PHI and CHI participants differed in age, CD4+ cell count, CSF VL, and CSF neopterin (p<0.005 for each). CHI had higher MD and lower FA (p?0.0001 vs. HIV-) compared to PHI and HIV- in the anterior CC. TBSS demonstrated similar changes in the anterior CC and the external capsule and forceps. In CHI individuals, MD and FA in the anterior CC from ROI analysis correlated with CSF neopterin and blood VL, and NPZ4 correlated (p<0.01) with FA.

Conclusions CONCLUSIONS: CHI participants had decreased FA and increased MD, suggesting disruption of WM compared to PHI and HIV- controls. Our results suggest that changes in WM integrity occur after initial infection and are associated with systemic infection, brain inflammation, and NP performance. Additional longitudinal studies are needed to assess the optimal time to initiate cART to prevent loss of WM integrity that occurs with progressive HIV infection.

Authors/Disclosures
Beau M. Ances, MD, PhD, MS, FAAN (Washington University in Saint Louis) PRESENTER	Dr. Ances has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH.
	No disclosure on file
	No disclosure on file
Dieter J. Meyerhoff	No disclosure on file
Richard W. Price, MD, FAAN (San Francisco General Hospital)	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Serena Spudich, MD (Yale University)	The institution of Dr. Spudich has received research support from NIH.

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