Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age.
ART interruption
Brain morphometry
Cortical thickness
Gyrification
Pediatric HIV
Journal
IBRO neuroscience reports
ISSN: 2667-2421
Titre abrégé: IBRO Neurosci Rep
Pays: Netherlands
ID NLM: 101775148
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
10
09
2020
accepted:
03
02
2021
entrez:
28
6
2021
pubmed:
29
6
2021
medline:
29
6
2021
Statut:
epublish
Résumé
ART interruption in children can occur especially in resource-limited settings for reasons including poor adherence, stock-outs, ART intolerance of non-pediatric formulas and pill size, as well as ultimately to test for HIV remission. Although early ART initiation is now standard of care in pediatric HIV management, very little is known on the effect of early ART initiation or subsequent interruption on brain development. This study aimed to investigate the effect of ART interruption on brain cortical thickness (CT) and folding in a subset of children from the Children with HIV Early antiRetroviral therapy (CHER) trial cohort who all started ART before 18 months of age. CHER participants in the neuroimaging follow-up study had magnetic resonance (MRI) scans on a 3T Siemens Allegra brain scanner at age 5.44 ± 0.37 years. MR images were processed using the automated cross-sectional stream in FreeSurfer v6.0 and vertex wise comparisons of CT and local gyrification indices (LGIs) were performed between HIV+ children and HIV- controls, as well as between HIV+ children on interrupted or continuous ART and controls. HIV+ children (n = 46) showed thicker cortex than HIV- children (n = 29) in bilateral frontal and left temporo-insular regions but lower LGIs in left superior and bilateral medial orbitofrontal cortex extending into rostral anterior cingulate. Children on interrupted ART (n = 21) had thicker cortex than HIV- controls in left frontal and right insular regions, but children on continuous treatment (n = 25) showed no difference from controls. Children on both interrupted and continuous ART showed region-specific alterations in LGI relative to controls. Cortical folding appears more sensitive than CT to early life events including early ART and interruption. However, immune health resilience in children can translate to long term preservation of morphometric brain development, especially for those on early and continuous treatment.
Identifiants
pubmed: 34179869
doi: 10.1016/j.ibneur.2021.02.001
pii: S2667-2421(21)00010-5
pmc: PMC8211921
doi:
Types de publication
Journal Article
Langues
eng
Pagination
161-170Subventions
Organisme : NICHD NIH HHS
ID : R01 HD071664
Pays : United States
Organisme : NIMH NIH HHS
ID : R21 MH096559
Pays : United States
Organisme : NIAID NIH HHS
ID : U19 AI053217
Pays : United States
Informations de copyright
© 2021 The Authors.
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