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Magnetic Resonance Imaging of Cerebral Small Vessel Disease in Men Living with HIV and HIV-Negative Men Aged 50 and Above

2019; Mary Ann Liebert, Inc.; Volume: 35; Issue: 5 Linguagem: Inglês

10.1089/aid.2018.0249

1931-8405

Lewis Haddow, Carole H. Sudre, Magdalena Sokolska, Richard Gilson, Ian Williams, Xavier Golay, Sébastien Ourselin, Alan Winston, Caroline Sabin, M. Jorge Cardoso, Hans Rolf Jäger, Marta Boffito, Patrick Mallon, Frank A. Post, Caroline Sabin, Memory Sachikonye, Alan Winston, Jane Anderson, David Asboe, Marta Boffito, Lucy Garvey, Patrick Mallon, Frank A. Post, Anton Pozniak, Caroline Sabin, Memory Sachikonye, Jaime H. Vera, Ian Williams, Alan Winston, Frank A. Post, Lucy Campbell, Selin Yurdakul, Sara Okumu, Louise Pollard, Ian Williams, Damilola Otiko, Laura L. Phillips, Rosanna Laverick, Michelle Beynon, Anna-Lena Salz, Martin Fisher, Amanda Clarke, Jaime H. Vera, Andrew Bexley, Celia Richardson, Patrick Mallon, Alan Macken, Bijan Ghavani-Kia, Joanne Maher, M. M. Byrne, Ailbhe Flaherty, Sumesh Babu, Jane Anderson, Sifiso Mguni, Rebecca A. Clark, Rhiannon Nevin-Dolan, Sambasivarao Pelluri, Margaret Johnson, Nnenna Ngwu, Nargis Hemat, Martin Jones, Anne Carroll, Andrew J. O. Whitehouse, Laura Burgess, Daphne Babalis, Alan Winston, Lucy Garvey, Jonathan Underwood, Matthew B. Stott, Linda McDonald, Marta Boffito, David Asboe, Anton Pozniak, Chris Higgs, Elisha Seah, Stephen Fletcher, Michelle Anthonipillai, Ashley Moyes, Katie Deats, Irtiza Syed, Clive Matthews, Peter Fernando, Caroline Sabin, Davide De Francesco, Emmanouil Bagkeris,

Neurological Complications and Syndromes

We assessed whether HIV status was associated with white matter hyperintensities (WMH), a neuroimaging correlate of cerebral small vessel disease (CSVD), in men aged ≥50 years. A cross-sectional substudy was nested within a larger cohort study. Virologically suppressed men living with HIV (MLWH) and demographically matched HIV-negative men aged ≥50 underwent magnetic resonance imaging (MRI) at 3 Tesla. Sequences included volumetric three-dimensional (3D) T1-weighted, fluid-attenuated inversion recovery and pseudocontinuous arterial spin labeling. Regional segmentation by automated image processing algorithms was used to extract WMH volume (WMHV) and resting cerebral blood flow (CBF). The association between HIV status and WMHV as a proportion of intracranial volume (ICV; log-transformed) was estimated using a multivariable linear regression model. Thirty-eight MLWH [median age 59 years (interquartile range, IQR 55–64)] and 37 HIV-negative [median 58 years (54–63)] men were analyzed. MLWH had median CD4+ count 570 (470–700) cells/μL and a median time since diagnosis of 20 (14–24) years. Framingham 10-year risk of cardiovascular disease was 6.5% in MLWH and 7.4% in controls. Two (5%) MLWH reported a history of stroke or transient ischemic attack and five (13%) reported coronary heart disease compared with none of the controls. The total WMHV in MLWH was 1,696 μL (IQR 1,229–3,268 μL) or 0.10% of ICV compared with 1,627 μL (IQR 1,032–3,077 μL), also 0.10% of ICV in the HIV-negative group (p = .43). In the multivariable model, WMHV/ICV was not associated with HIV status (p = .86). There was an age-dependent decline in cortical CBF [−3.9 mL/100 mL/min per decade of life (95% confidence interval 1.1–6.7 mL)] but no association between CBF and HIV status (p > .2 in all brain regions analyzed). In conclusion, we found no quantitative MRI evidence of an increased burden of CSVD in MLWH aged 50 years and older.