Soon after an individual’s initial infection with HIV, damage to brain volume and cortical thickness progressively worsens until anti-retroviral treatment is started, a new study shows.
“We knew HIV could cause neurological damage, but we did not know it happened so early in the infection,” said Serena Spudich, professor of neurology at Yale and co-senior author of the paper published in the journal Clinical Infectious Diseases. “The findings emphasize the importance of identifying infected people early and treating them so we can halt its progression.”
Scientists at the Montreal Neurological Institute and Hospital of McGill University analyzed MRI data from 65 HIV-positive patients who had been longitudinally studied by Spudich. Their analysis found that the longer duration of infection before anti-retroviral treatment, the more damage was found in a variety of brain areas.
An estimated 36.7 million people live with the infection but less than half have access to combination anti-retroviral treatment, which has extended the lifespan of millions of HIV patients.
Longer delays in treatment led to greater volume loss in the thalamus, caudate, and cerebellum, and to greater the cortical thinning in the frontal and temporal lobes, and cingulate cortex. Once combination retroviral treatment began, the volume changes in these regions stopped, and cortical thickness increased slightly in the frontal and temporal lobe, the study found.
Publication: Ryan Sanford, et al., “Longitudinal Trajectories of Brain Volume and Cortical Thickness in Treated and Untreated Primary HIV Infection,” Clinical Infectious Diseases, 2018; doi:10.1093/cid/ciy362