The Effect of Central Nervous System Penetration Effectiveness of Highly Active Antiretroviral Therapy on Neuropsychological Performance and Neuroimaging in HIV Infected Individuals

Laurie M. Baker, Robert H. Paul, Jodi M. Heaps-Woodruff, Jee Yoon Chang, Mario Ortega, Zachary Margolin, Christina Usher, Brian Basco, Sarah Cooley, Beau M. Ances

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

The incidence of HIV-associated dementia has been greatly reduced in the era of highly active antiretroviral therapy (HAART); however milder forms of cognitive impairment persist. It remains uncertain whether HAART regimens with a high degree of central nervous system penetration effectiveness (CPE) exert beneficial neurological outcomes in HIV-infected (HIV+) individuals on stable treatment. Sixty-four HIV-infected adults on HAART were assigned a CPE score using a published ranking system and divided into high (≥7; n = 35) and low (<7; n = 29) CPE groups. All participants completed neuropsychological testing in addition to structural neuroimaging. Neuropsychological tests included measures known to be sensitive to HIV with values converted into standardized scores (NPZ-4) based on published normative scores. A semi-automated methodology was utilized to assess brain volumetrics within cortical (grey and white matter) and subcortical (thalamus, caudate, putamen) regions of interest. Analyses assessed NPZ-4 and brain volumetric differences between HIV+ individuals with high and low CPE scores. No significant differences in brain integrity were observed between the two groups. Long-term HAART regimens with a high degree of CPE were not associated with significantly improved neuropsychological or neuroimaging outcomes in HIV+ adults. Results suggest that alternate mechanisms may potentially contribute to better neurological outcomes in the era of HAART.

Original languageEnglish
Pages (from-to)487-492
Number of pages6
JournalJournal of Neuroimmune Pharmacology
Volume10
Issue number3
DOIs
StatePublished - Sep 22 2015

Keywords

  • Brain volumetrics
  • CPE
  • HIV
  • Magnetic resonance imaging
  • Neuropsychological performance

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