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Silent Cerebral Small-Vessel Disease Is Twice as Prevalent in Middle-Aged Individuals With Well-Controlled, Combination Antiretroviral Therapy–Treated Human Immunodeficiency Virus (HIV) Than in HIV-Uninfected Individuals

2017; Oxford University Press; Volume: 66; Issue: 11 Linguagem: Inglês

10.1093/cid/cix1075

1537-6591

Antoine Moulignier, Julien Savatovsky, Lambert Assoumou, François-Xavier Lescure, C. Lamirel, O. Godin, Nadia Valin, Roland Tubiana, Ana Canestri, Pascal Roux, Jean‐Claude Sadik, Laurence Salomon, Marie Abrivard, Christine Katlama, Yazdan Yazdanpanah, Gilles Pialoux, Pierre‐Marie Girard, Dominique Costagliola, Antoine Moulignier, Antoine Moulignier, Corinne Amiel, Lambert Assoumou, Ana Canestri, I. Cochereau, J. Capeau, Dominique Costagliola, O. Godin, Philippe Girard, Christine Katlama, C. Lamirel, François‐Xavier Lescure, Lucie Marchand, Mikaël Mazighi, Martine Obadia, Michel Pâques, Gilles Pialoux, Emmanuelle Plaisier, Roland Tubiana, Nadia Valin, Yazdan Yazdanpanah, P. Yéni, Antoine Moulignier, Marie Abrivard, Angelika Alonso, I. Cochereau, Pierre Koskas, C. Lamirel, Letícia Barroquelo Viana Lopes, Mikaël Mazighi, Martine Obadia, Pierre‐Yves Le Roux, Jean‐Claude Sadik, Laurence Salomon, Julien Savatovsky, Virginie Vasseur, François‐Xavier Lescure, M. Chansombat, Roland Landman, Bao-Chau Phung, Djamila Rahli, Yazdan Yazdanpanah, P. Yéni, Christine Katlama, L Lenclume, Roland Tubiana, Marc‐Antoine Valantin, Philippe Girard, J.‐L. Meynard, Manuela Sébire, Nadia Valin, Gilles Pialoux, A Adda Liévin, Corinne Amiel, J.P. Bastard, Ana Canestri, J. Capeau, Soraya Fellahi, Marie Gisèle Lebrette, Emmanuelle Plaisier, P Thibaut, Michel Pâques, Dominique Costagliola, Lambert Assoumou, Georges Dos Santos, O. Godin, Lucie Marchand, Philippe Girard, Jean-Paul Vincensini,

Intracerebral and Subarachnoid Hemorrhage Research

Silent cerebral small-vessel disease (CSVD) is defined as white matter hyperintensities, silent brain infarction, or microbleeds. CSVD is responsible for future vascular events, cognitive impairment, frailty, and shorter survival. CSVD prevalence among middle-aged people living with well-controlled human immunodeficiency virus (HIV) infection (PLHIV) is unknown.The French National Agency for Research on AIDS and Viral Hepatitis (ANRS) EP51 Microvascular Brain Retina and Kidney Study (MicroBREAK; NCT02082574) is a cross-sectional study with prospective enrollment of treated PLHIV, ≥50 years old with viral load controlled for ≥12 months, and frequency age- and sex-matched HIV-uninfected controls (HUCs). It was designed to estimate CSVD prevalence on 3T magnetic resonance imaging (3D fluid-attenuated inversion recovery, transversal T2-weighted gradient-echo imaging and diffusion-weighted imaging), as diagnosed by 2 blinded neuroradiologists. A logistic regression model was used to assess the impact of HIV on CSVD after adjustment for traditional risk factors.Between June 2013 and May 2016, 456 PLHIV and 154 HUCs were recruited. Median age was 56 and 58 years, respectively (P = .001), among whom 84.9% and 77.3%, respectively (P = .030), were men. CSVD was detected in 51.5% of PLHIV and 36.4% of HUCs with an adjusted odds ratio (aOR) of 2.3. The HIV impact differed according to age, with aOR values of 5.3, 3.7, and 1.0 for age groups 60 years, respectively (P = .022). Older age, hypertension, and lower CD4 cell count nadir were independently associated with a higher risk of CSVD among PLHIV.HIV is an independent risk factor for CSVD. Despite sustained immunovirological control, the CSVD prevalence was twice as high among middle-aged PLHIV than HUCs.NCT02082574.