Abstract Details

Title Abnormal Brain Pathology in Virologically Controlled HIV-Infected Individuals

Topic Infections/AIDS/Prion Disease

Presentation(s) S38 - (-)

Poster/Presentation
Number 003

Objective

Background HIV positive individuals frequently show neurocognitive deficits despite adequate ART, however it remains unknown if there are any associated pathological abnormalities in the brain.

Design/Methods Brains of seven HIV-infected individuals on ART were obtained from the Texas Repository for AIDS Neuropathogenesis Research. Each had low viral load (<500 copies/ml) in plasma prior to death. Mean age was 56.1 (±10.65). We performed immunohistochemistry (IHC) using multiple neuronal, glial and virological markers.

Results Immunostaining for neurofilament and amyloid precursor protein showed disruption and beading of axons as well as cytoplasmic staining for neurofilament in neurons indicating neuronal injury and impaired axonal transport. Prominent astrocytosis was noted by immunostaining for glial fibrillary acidic protein. The HIV protein p24 was not detected by IHC in any of the samples, but HIV protein Tat was present in microglial nodules, vascular structures and perivascular parenchyma indicating that early viral proteins could be produced despite ART.

Conclusions In this study we show that brains of individuals with HIV infection have morphological evidence of neuro-glial abnormalities even in individuals who are virologically controlled. The findings of neuronal damage in the absence of p24 but with marked Tat expression, may indicate that Tat plays a role in the pathogenesis of CNS injury seen this HIV-infected population.

Authors/Disclosures
Gloria Von Geldern, MD, FAAN (University of Washington) PRESENTER	The institution of Dr. Von Geldern has received research support from Novartis. The institution of Dr. Von Geldern has received research support from Contineum Therapeutics. Dr. Von Geldern has received personal compensation in the range of $0-$499 for serving as a DSMB member with NIH, NINDS. Dr. Von Geldern has a non-compensated relationship as a editorial board member with MS and Related Disorders Journal that is relevant to AAN interests or activities.
Avindra Nath, MD, MBBS, FAAN (National Institutes of Health)	The institution of Dr. Nath has received research support from National Institutes of Health. The institution of Dr. Nath has received research support from Target ALS. Dr. Nath has received intellectual property interests from a discovery or technology relating to health care.
	No disclosure on file

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