Journal Article10.1007/S11682-018-9966-1
Cerebral white matter Hyperintensities in HIV-positive patients.
Alice Trentalange,Adolfo Prochet,Daniele Imperiale,Jessica Cusato,Mariacristina Tettoni,Giuseppe Nunnari,Ambra Barco,Stefano Bonora,Giovanni Di Perri,Andrea Calcagno +9 more
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TL;DR: In this population of HIV-positive patients with low CD4 nadir and partial CD4 cell recovery the burden of WMHs was associated with the duration of HIV infection and with commonly observed comorbidities (such as renal and hepatic impairment).
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Abstract: White matter hyperintensities (WMHs) have been associated with neurological complications including cognitive impairment. WMHs have been often described in HIV positive subjects and they have been linked to neurocognitive impairment, cerebrospinal fluid (CSF) residual viral replication and biomarkers of monocyte activation. Aim of this study was to grade WMHs in HIV-positive individuals using a simple visual scale and to explore their severity with clinical, neurocognitive and biomarker characteristics. Brain MRIs were retrospectively evaluated by two reviewers who rated WMHs following the “age-related white matter changes (ARWMC)” scale. 107 adult HIV-positive patients receiving lumbar punctures for clinical reasons were included. 70 patients (66.6%) were diagnosed with WMHs. Average WMH scores were higher in treated [7 (1–11)] vs. naive individuals [3 (0–6)] (p = 0.008). Higher WHMs scores were observed in patients with chronic renal impairment along with chronic hepatitis (naive) and longer HIV duration (treated participants). No consistent associations between plasma, CSF biomarkers and WMHs scores were found. 45 patients underwent full neurocognitive tests and WMHs scores were non-significantly higher in patients diagnosed with HAND [6.5 (0.5–8.3) vs. 1.5 (0–7), p = 0.165]; screening (IHDS and FAB), visuo-spatial (Corsi’s) and auditory-verbal memory (disillabic words repetition) tests scored worse in patients with higher WMHs. In our population of HIV-positive patients with low CD4 nadir and partial CD4 cell recovery the burden of WMHs was associated with the duration of HIV infection and with commonly observed comorbidities (such as renal and hepatic impairment). Given the association with worse neurocognition, further studies on tailored interventions are needed.
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Citations
HIV-Associated Neurocognitive Impairment in the Modern ART Era: Are We Close to Discovering Reliable Biomarkers in the Setting of Virological Suppression?
Alessandra Bandera,Lucia Taramasso,Giorgio Bozzi,Antonio Muscatello,Jake A. Robinson,Tricia H. Burdo,Andrea Gori,Andrea Gori +7 more
TL;DR: The aim of the present study is to review the body of evidence on different biomarkers use in research and clinical settings, focusing on PWH on ART with undetectable plasma HIV-RNA.
Association of White Matter Hyperintensities with HIV Status and Vascular Risk Factors
Yair Mina,Yair Mina,Tianxia Wu,Hsing-Chuan Hsieh,Hsing-Chuan Hsieh,Dima A. Hammoud,Swati Shah,Chuen-Yen Lau,Lillian Ham,Joseph Snow,Elizabeth Horne,Anuradha Ganesan,Anuradha Ganesan,Stanley I. Rapoport,Edmund C. Tramont,Daniel S. Reich,Brian K. Agan,Brian K. Agan,Avindra Nath,Bryan Smith +19 more
TL;DR: In this article, the authors used the Fazekas visual rating scale to identify clinical measures that correlate with brain white matter hyperintensities (WMH) in people living with HIV.
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•Journal Article
Severe Cerebral White Matter Hyperintensities Predict Severe Cognitive Decline in Patients With Cerebrovascular Disease History
CaroleDufouil,OphéliaGodin,JohnChalmers,OghuzanCoskun,StephenMacMahon,NathalieTzourio-Mazoyer,Marie-GermaineBousser,CraigAnderson,BernardMazoyer,ChristopheTzourio +9 more
TL;DR: Higher WMH load is a strong predictor of dementia and cognitive decline in patients with cerebrovascular disease history, and is associated with baseline severe WMHs.
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Metabolic Syndrome and Cardiovascular Disease Impacts on the Pathophysiology and Phenotype of HIV-Associated Neurocognitive Disorders.
TL;DR: This review highlights the correspondences observed between the findings concerning CVD and MetS in the general population and virus-suppressed cART-treated PLHIVs to evaluate the real brain-aging processes and suggests that CV/metabolic comorbidities could be implicated in the pathogenesis of HIV-associated neurocognitive disorders (HAND).
Serum and CSF biomarkers in asymptomatic patients during primary HIV infection: a randomized study
Andrea Calcagno,Jessica Cusato,Paola Cinque,Giulia Maria Marchetti,Davide Paolo Bernasconi,Mattia Trunfio,Elena Bruzzesi,Stefano Rusconi,Arianna Gabrieli,Antonio Muscatello,Adriana Ammassari,Diego Ripamonti,Roberto Gulminetti,Miriam Antonucci,Silvia Nozza +14 more
TL;DR: This randomized study of asymptomatic HIV patients during primary infection found significant correlations between serum and CSF biomarkers, including NFL, GFAP, and BDNF, and a decrease in serum NFL and GFAP levels after antiretroviral therapy initiation.
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Age exacerbates HIV-associated white matter abnormalities.
Talia R. Seider,Assawin Gongvatana,Adam J. Woods,Huaihou Chen,Eric C. Porges,Tiffany Cummings,Stephen Correia,Karen T. Tashima,Ronald A. Cohen +8 more
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