Clinical factors related to brain structure in HIV: the CHARTER study.
Clinical factors related to brain structure in HIV: the CHARTER study.
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DOI：
10.1007/s13365-011-0032-7
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发表时间：
2011-06
影响因子：
3.2
通讯作者：
Grant, Igor
中科院分区：
文献类型：
--
作者：
Jernigan, Terry L.;Archibald, Sarah L.;Fennema-Notestine, Christine;Taylor, Michael J.;Theilmann, Rebecca J.;Julaton, Michelle D.;Notestine, Randy J.;Wolfson, Tanya;Letendre, Scott L.;Ellis, Ronald J.;Heaton, Robert K.;Gamst, Anthony C.;Franklin, Donald R., Jr.;Clifford, David B.;Collier, Ann C.;Gelman, Benjamin B.;Marra, Christina;McArthur, Justin C.;McCutchan, J. Allen;Morgello, Susan;Simpson, David M.;Grant, Igor
尽管联合抗逆转录病毒疗法(ART)的使用范围越来越广，但神经认知障碍在艾滋病毒感染者(HIV+)中仍然很常见。HIV相关的神经医学变量和脑部结构完整性的磁共振成像指数之间的关联可能提供对这些症状的神经基础的洞察。通过CNS艾滋病毒抗逆转录病毒治疗效果研究倡议，对不同的HIV+样本(n=251)进行了研究。多道图像分析显示脑室和脑沟脑脊液、皮质和皮质下灰质、全脑白质和异常白质体积。横断面分析采用一系列多元线性回归将每个结构体积建模为先前免疫抑制的严重程度(CD4最低点)、当前的CD4计数、可检测到的脑脊液HIV RNA的存在和丙型肝炎病毒抗体的存在；二次分析检查了血浆HIV RNA、估计的HIV感染持续时间和累积的ART暴露。较低的CD4值与大多数脑结构损伤指标有关。出乎意料的是，较高的CD4电流与较低的白质和皮质下灰度值以及较高的脑脊液含量相关。脑脊液中可检测到的HIV RNA与脑白质总量较少有关。丙型肝炎病毒合并感染患者脑白质异常较多。接受抗逆转录病毒治疗的时间越长，脑白质减少，脑脊液越高。HIV神经医学因素，包括较低的最低值、较高的当前CD4水平和可检测到的HIV RNA，与白质损伤和皮质下体积的变异性有关。HIV的大脑结构完整性可能反映了当前免疫状态和HIV复制的动态影响，叠加在与严重先前免疫抑制相关的残余影响上。
Despite the widening use of combination anti-retroviral therapy (ART), neurocognitive impairment remains common among HIV-infected (HIV+) individuals. Associations between HIV-related neuromedical variables and magnetic resonance imaging indices of brain structural integrity may provide insight into the neural bases for these symptoms. A diverse HIV+ sample (n=251) was studied through the CNS HIV Antiretroviral Therapy Effects Research initiative. Multi-channel image analysis produced volumes of ventricular and sulcal cerebrospinal fluid (CSF), cortical and subcortical gray matter, total cerebral white matter, and abnormal white matter. Cross-sectional analyses employed a series of multiple linear regressions to model each structural volume as a function of severity of prior immunosuppression (CD4 nadir), current CD4 count, presence of detectable CSF HIV RNA, and presence of HCV antibodies; secondary analyses examined plasma HIV RNA, estimated duration of HIV infection, and cumulative exposure to ART. Lower CD4 nadir was related to most measures of the structural brain damage. Higher current CD4, unexpectedly, correlated with lower white and subcortical gray and increased CSF. Detectable CSF HIV RNA was related to less total white matter. HCV coinfection was associated with more abnormal white matter. Longer exposure to ART was associated with lower white matter and higher sulcal CSF. HIV neuromedical factors, including lower nadir, higher current CD4 levels, and detectable HIV RNA, were associated with white matter damage and variability in subcortical volumes. Brain structural integrity in HIV likely reflects dynamic effects of current immune status and HIV replication, superimposed on residual effects associated with severe prior immunosuppression.
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影响因子：
3.2
作者：
Heaton, Robert K.;Franklin, Donald R.;Ellis, Ronald J.;McCutchan, J. Allen;Letendre, Scott L.;LeBlanc, Shannon;Corkran, Stephanie H.;Duarte, Nichole A.;Clifford, David B.;Woods, Steven P.;Collier, Ann C.;Marra, Christina M.;Morgello, Susan;Mindt, Monica Rivera;Taylor, Michael J.;Marcotte, Thomas D.;Atkinson, J. Hampton;Wolfson, Tanya;Gelman, Benjamin B.;McArthur, Justin C.;Simpson, David M.;Abramson, Ian;Gamst, Anthony;Fennema-Notestine, Christine;Jernigan, Terry L.;Wong, Joseph;Grant, Igor
通讯作者：
Grant, Igor
影响因子：
--
作者：
JERNIGAN, TL;ARCHIBALD, S;GRANT, I
通讯作者：
GRANT, I
影响因子：
3.3
作者：
Cloak, CC;Chang, L;Ernst, T
通讯作者：
Ernst, T
影响因子：
17.7
作者：
Chang, L;Ernst, T;Grob, CS
通讯作者：
Grob, CS
影响因子：
3.8
作者：
Letendre, SL;Cherner, M;Grant, I
通讯作者：
Grant, I