Differences in location of cerebral white matter hyperintensities in children and adults living with a treated HIV infection: A retrospective cohort comparison

• Published in: PloS one 2020-10, Vol.15 (10), p.e0241438-e0241438
• Main Authors: van Genderen, Jason G, Van den Hof, Malon, Boyd, Anders C, Caan, Matthan W A, Wit, Ferdinand W N M, Reiss, Peter, Pajkrt, Dasja
• Format: Article
• Language: English
• Subjects: Adolescent; Adults; Age; Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral drugs; Antiretroviral therapy; Biology and Life Sciences; Brain diseases; CD4 antigen; Cerebral white matter; Child; Children; Cohort Studies; Complications and side effects; Demography; Development and progression; Disease age factors; Female; Health aspects; Health care; HIV; HIV infections; HIV Infections - diagnostic imaging; HIV Infections - drug therapy; HIV Infections - pathology; HIV Infections - physiopathology; Hospitals; Human immunodeficiency virus; Humans; Hypertension; Infections; Infectious diseases; Lymphocytes; Lymphocytes T; Magnetic Resonance Imaging; Male; Medical imaging; Medicine and Health Sciences; Middle Aged; Organ Size - drug effects; Pathogenesis; Pediatric research; Pediatrics; People and Places; Physiological aspects; Research and Analysis Methods; Retrospective Studies; Ribonucleic acid; Risk factors; RNA; Substantia alba; Ventricle (lateral); White Matter - diagnostic imaging; White Matter - drug effects; White Matter - pathology; White Matter - physiopathology
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241438

Cerebral white matter hyperintensities (WMH) persist in children and adults living with HIV, despite effective combination antiretroviral therapy (cART). As age and principal routes of transmission differ between children (perinatally) and adults (behaviorally), comparing the characteristics and determinants of WMH between these populations may increase our understanding of the pathophysiology of WMH. From separate cohorts of 31 children (NOVICE) and 74 adults (AGEhIV), we cross-sectionally assessed total WMH volume and number of WMH per location (periventricular vs. deep) using fluid-attenuated inversion recovery (FLAIR) MRI images. WMH were either periventricular when within 10mm of the lateral ventricles, or deep otherwise. We assessed patient- or HIV-related determinants of total WMH volume (adjusted for intracranial volume) and location of WMH using logistic regression, while stratifying on children and adults. At enrollment, median age of participants was 13.8 years (IQR 11.4-15.9) for children and 53.4 years (IQR 48.3-60.8) for adults and 27/31 children (87%) and 74/74 adults (100%) had an HIV RNA viral load