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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

Haddow, L; Sudre, CH; Sokolska, M; Gilson, RC; Williams, I; Golay, X; Ourselin, S; ... Jäger, R; + view all (2019) Magnetic resonance imaging of cerebral small vessel disease in men living with HIV and HIV negative men aged 50 and above. AIDS Research and Human Retroviruses , 35 (5) pp. 453-460. 10.1089/AID.2018.0249. Green open access

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Abstract

We assessed whether HIV status was associated with white matter hyperintensities (WMH), a neuroimaging correlate of cerebral small vessel disease, 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 3D T1-weighted, FLAIR and pseudocontinuous arterial spin labelling. 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/microliter 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 ischaemic attack (TIA) and five (13%) reported coronary heart disease (CHD) compared to none of the controls. The total WMHV in MLWH was 1696 microliters (IQR 1229, 3268 microliters) or 0.10% of ICV compared to 1627 microliters (IQR 1032, 3077 microliters), also 0.10% of ICV, in the HIV negative group (p=0.43). In the multivariable model, WMHV/ICV was not associated with HIV status (p=0.86). There was an age-dependent decline in cortical CBF (-3.9 ml/100ml/min per decade of life [95% CI 1.1 to 6.7 ml]) but no association between CBF and HIV status (p>0.2 in all brain regions analyzed). In conclusion, we found no quantitative MRI evidence of an increased burden of cerebral small vessel disease in MLWH aged 50 years and over.

Type: Article
Title: Magnetic resonance imaging of cerebral small vessel disease in men living with HIV and HIV negative men aged 50 and above
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1089/AID.2018.0249
Publisher version: https://doi.org/10.1089/AID.2018.0249
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Med Phys and Biomedical Eng
URI: https://discovery.ucl.ac.uk/id/eprint/10067124
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