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dc.contributor.authorNir, Talia M
dc.contributor.authorFouche, Jean-Paul
dc.contributor.authorAnanworanich, Jintanat
dc.contributor.authorAnces, Beau M
dc.contributor.authorBoban, Jasmina
dc.contributor.authorBrew, Bruce J
dc.contributor.authorChaganti, Joga R
dc.contributor.authorChang, Linda
dc.contributor.authorChing, Christopher R K
dc.contributor.authorCysique, Lucette A
dc.contributor.authorErnst, Thomas
dc.contributor.authorFaskowitz, Joshua
dc.contributor.authorGupta, Vikash
dc.contributor.authorHarezlak, Jaroslaw
dc.contributor.authorHeaps-Woodruff, Jodi M
dc.contributor.authorHinkin, Charles H
dc.contributor.authorHoare, Jacqueline
dc.contributor.authorJoska, John A
dc.contributor.authorKallianpur, Kalpana J
dc.contributor.authorKuhn, Taylor
dc.contributor.authorLam, Hei Y
dc.contributor.authorLaw, Meng
dc.contributor.authorLebrun-Frénay, Christine
dc.contributor.authorLevine, Andrew J
dc.contributor.authorMondot, Lydiane
dc.contributor.authorNakamoto, Beau K
dc.contributor.authorNavia, Bradford A
dc.contributor.authorPennec, Xavier
dc.contributor.authorPorges, Eric C
dc.contributor.authorSalminen, Lauren E
dc.contributor.authorShikuma, Cecilia M
dc.contributor.authorSurento, Wesley
dc.contributor.authorThames, April D
dc.contributor.authorValcour, Victor
dc.contributor.authorVassallo, Matteo
dc.contributor.authorWoods, Adam J
dc.contributor.authorThompson, Paul M
dc.contributor.authorCohen, Ronald A
dc.contributor.authorPaul, Robert
dc.contributor.authorStein, Dan J
dc.contributor.authorJahanshad, Neda
dc.date.accessioned2021-02-08T17:48:23Z
dc.date.available2021-02-08T17:48:23Z
dc.date.issued2021-01-04
dc.identifier.urihttp://hdl.handle.net/10713/14504
dc.description.abstractImportance: Despite more widely accessible combination antiretroviral therapy (cART), HIV-1 infection remains a global public health challenge. Even in treated patients with chronic HIV infection, neurocognitive impairment often persists, affecting quality of life. Identifying the neuroanatomical pathways associated with infection in vivo may delineate the neuropathologic processes underlying these deficits. However, published neuroimaging findings from relatively small, heterogeneous cohorts are inconsistent, limiting the generalizability of the conclusions drawn to date. Objective: To examine structural brain associations with the most commonly collected clinical assessments of HIV burden (CD4+ T-cell count and viral load), which are generalizable across demographically and clinically diverse HIV-infected individuals worldwide. Design, Setting, and Participants: This cross-sectional study established the HIV Working Group within the Enhancing Neuro Imaging Genetics Through Meta Analysis (ENIGMA) consortium to pool and harmonize data from existing HIV neuroimaging studies. In total, data from 1295 HIV-positive adults were contributed from 13 studies across Africa, Asia, Australia, Europe, and North America. Regional and whole brain segmentations were extracted from data sets as contributing studies joined the consortium on a rolling basis from November 1, 2014, to December 31, 2019. Main Outcomes and Measures: Volume estimates for 8 subcortical brain regions were extracted from T1-weighted magnetic resonance images to identify associations with blood plasma markers of current immunosuppression (CD4+ T-cell counts) or detectable plasma viral load (dVL) in HIV-positive participants. Post hoc sensitivity analyses stratified data by cART status. Results: After quality assurance, data from 1203 HIV-positive individuals (mean [SD] age, 45.7 [11.5] years; 880 [73.2%] male; 897 [74.6%] taking cART) remained. Lower current CD4+ cell counts were associated with smaller hippocampal (mean [SE] β = 16.66 [4.72] mm3 per 100 cells/mm3; P < .001) and thalamic (mean [SE] β = 32.24 [8.96] mm3 per 100 cells/mm3; P < .001) volumes and larger ventricles (mean [SE] β = -391.50 [122.58] mm3 per 100 cells/mm3; P = .001); in participants not taking cART, however, lower current CD4+ cell counts were associated with smaller putamen volumes (mean [SE] β = 57.34 [18.78] mm3 per 100 cells/mm3; P = .003). A dVL was associated with smaller hippocampal volumes (d = -0.17; P = .005); in participants taking cART, dVL was also associated with smaller amygdala volumes (d = -0.23; P = .004). Conclusions and Relevance: In a large-scale international population of HIV-positive individuals, volumes of structures in the limbic system were consistently associated with current plasma markers. Our findings extend beyond the classically implicated regions of the basal ganglia and may represent a generalizable brain signature of HIV infection in the cART era.en_US
dc.description.urihttps://doi.org/10.1001/jamanetworkopen.2020.31190en_US
dc.language.isoenen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.ispartofJAMA Network Openen_US
dc.subjectcross-sectional studyen_US
dc.subjectneuroimagesen_US
dc.subjectsubcortical brain volumeen_US
dc.subjectEnhancing Neuro Imaging Genetics through Meta Analysis (ENIGMA). HIV Working Groupen_US
dc.subject.meshCognitive Dysfunctionen_US
dc.subject.meshHIV-1en_US
dc.subject.meshImmunosuppressionen_US
dc.subject.meshViral Loaden_US
dc.titleAssociation of Immunosuppression and Viral Load With Subcortical Brain Volume in an International Sample of People Living With HIVen_US
dc.typeArticleen_US
dc.identifier.doi10.1001/jamanetworkopen.2020.31190
dc.identifier.pmid33449093
dc.source.volume4
dc.source.issue1
dc.source.beginpagee2031190
dc.source.endpage
dc.source.countryUnited States


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