Diffusion basis spectral imaging detects ongoing brain inflammation in virologically well-controlled HIV+ Patients

Jeremy F. Strain, Tricia H. Burdo, Sheng Kwei Song, Peng Sun, Omar El-Ghazzawy, Brittany Nelson, Elizabeth Westerhaus, Laurie Baker, Florin Vaida, Beau M. Ances

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Inflammation occurs after HIV infection and persists, despite highly active antiretroviral therapy (HAART). Diffusion tensor imaging (DTI) measures HIV-associated white matter changes, but can be confounded by inflammation. Currently, the influence of inflammation on white matter integrity in well-controlled HIV+ patients remains unknown. We used diffusion basis spectral imaging (DBSI)-derived cellularity to isolate restricted water diffusion associated with inflammation separated from the anisotropic diffusion associated with axonal integrity. Ninety-two viro-logically suppressed HIV+ patients on HAART and 66 HIV uninfected (HIV -) controls underwent neuropsychological performance (NP) testing and neuroimaging. NP tests assessed multiple domains (memory, psychomotor speed, and executive functioning). DTI- and DBSI-derived fractional anisotropy (FA) maps were processed with tract-based spatial statistics for comparison between both groups. Cellularity was assessed regarding age, HIV status, and NP. Within the HIV+ cohort, cellularity was compared with clinical (HAART duration) and laboratory measures of disease (eg, CD4 cell current and nadir). NP was similar for both groups. DTI-derived FA was lower in HIV+ compared with HIV - individuals. By contrast, DBSI-derived FA was similar for both groups. Instead, diffuse increases in cellularity were present in HIV+ individuals. Observed changes in cellularity were significantly associated with age, but not NP, in HIV+ individuals. A trend level association was seen between cellularity and HAART duration. Elevated inflammation, measured by cellularity, persists in virologically well-controlled HIV+ individuals. Widespread cellularity changes occur in younger HIV+ individuals and diminish with aging and duration of HAART.

Original languageEnglish
Pages (from-to)423-430
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume76
Issue number4
DOIs
StatePublished - 2017

Keywords

  • Cellularity
  • Diffusion basis spectral imaging
  • Diffusion tensor imaging
  • HIV
  • Inflammation

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