Neurocognitive profile of patients with early stages of HIV infection

2017 ◽  
Vol 41 (S1) ◽  
pp. s505-s506
Author(s):  
P. Garcia ◽  
D. Hernandez ◽  
C. Fillizola ◽  
J.M. Santacruz ◽  
H. Santamaría García
Keyword(s):  
Hiv Infection ◽  
Neurocognitive Disorders ◽  
Aids Dementia Complex ◽  
Control Group ◽  
Hiv Patients ◽  
Metabolic Encephalopathy ◽  
Early Stages ◽  
Neurocognitive Profile ◽  
Cognitive Alterations ◽  
Hiv Associated Neurocognitive Disorders

HIV-associated neurocognitive disorders (HAND) may include neurological disorders of various severities such as AIDS dementia complex (ADC) also known as HIV dementia and HIV-associated dementia (HAD), HIV encephalopathy, and Mild Neurocognitive Disorder (MND). As it seems HIV-associated neurocognitive disorders are associated with a metabolic encephalopathy induced by HIV infection and fueled by immune activation of macrophages and microglia. Despite of a group, evidences have described presence of cognitive alterations in HIV patients at different stages of HIV infection so far; little is known about the neurocognitive state of patients at very early stages of HIV infection. Here, we explored the neurocognitive profile of a group of cases of HIV patients at very early stages of HIV infection. We have analyzed of three groups of subjects, thus, we have studied a group of patients with early HIV infection, a healthy control group and a group of patients with mild cognitive impairment due to neurodegenerative causes. Our results suggested that cognitive processes are sensitive to very early neuropathological changes in HIV infection. Noteworthy, our results also showed that neurocognitive profile of HIV patients differs from those cognitive alterations in patients with mild cognitive disorders associated to primary neurodegeneration. Together, our results point out that HIV infection generates neural changes even at early stages of infection. Furthermore, our results highlight the importance of a deep neurocognitive exploration at very early stages of HIV infection as this approach allow improve the accompaniment, clinical attachment and interventions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Erratum to ‘HMGB1/anti-HMGB1 antibodies define a molecular signature of early stages of HIV-Associated Neurocognitive Disorders (HAND)’

Heliyon ◽  
2017 ◽  
Vol 3 (3) ◽  
pp. e00259
Author(s):  
Marie-Lise Gougeon ◽  
Béatrice Poirier-Beaudouin ◽  
Jacques Durant ◽  
Christine Lebrun-Frenay ◽  
Héla Saïdi ◽  
...  
Keyword(s):  
Neurocognitive Disorders ◽  
Molecular Signature ◽  
Early Stages ◽  
Hiv Associated Neurocognitive Disorders

scholarly journals Abundance of Nef and p-Tau217 in Brains of Individuals Diagnosed with HIV-Associated Neurocognitive Disorders Correlate with Disease Severance

2021 ◽  
Author(s):  
Tatiana Pushkarsky ◽  
Adam Ward ◽  
Andrey Ivanov ◽  
Xionghao Lin ◽  
Dmitri Sviridov ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Hiv Infection ◽  
Lipid Rafts ◽  
Cholesterol Efflux ◽  
Neurocognitive Disorders ◽  
Postmortem Brain ◽  
The Brain ◽  
Hiv 1 ◽  
Hiv Associated Neurocognitive Disorders

AbstractHIV-associated neurocognitive disorders (HAND) is a term used to describe a variety of neurological impairments observed in HIV-infected individuals. The pathogenic mechanisms of HAND and of its connection to HIV infection remain unknown, but one of the considered hypotheses suggests that HIV infection accelerates the development of Alzheimer’s disease. Previous studies suggested that HIV-1 Nef may contribute to HAND by inhibiting cholesterol efflux, increasing the abundance of lipid rafts, and affecting their functionality. Our comparative analysis of postmortem brain samples demonstrated a trend toward the decreased abundance of cholesterol transporter ABCA1 in samples from HIV-infected ART-treated individuals relative to samples from uninfected controls, and a reverse correlation between ABCA1 and flotillin 1, a marker for lipid rafts, in all analyzed samples. The brain samples from HIV-infected individuals, both with and without HAND, were characterized by the increased abundance of p-Tau217 peptide, which correlated with the abundance of flotillin 1. HIV-1 Nef was analyzed in samples from HAND-affected individuals by Western blot with 4 different antibodies and by LC–MS/MS, producing a Nef-positivity score. A significant correlation was found between this score and the abundance of flotillin 1, the abundance of p-Tau217, and the severity of HAND. These results highlight the contribution of Nef and Nef-dependent impairment of cholesterol efflux to HAND pathogenesis and support a connection between the pathogenesis of HAND and Alzheimer’s disease.

scholarly journals Unexpected Increase of Myocardial Extracellular Volume Fraction in Low Cardiovascular Risk HIV Patients

2020 ◽  
Author(s):  
Cristian Borrazzo ◽  
Gabriella d'Ettorre ◽  
Giancarlo Ceccarelli ◽  
Massimiliano Pacilio ◽  
Letizia Santinelli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
General Population ◽  
Hiv Infection ◽  
Volume Fraction ◽  
Control Group ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Age And Gender ◽  
And Gender ◽  
Asymptomatic Hiv

Abstract Background: People living with HIV (PLWH) are prone to develop sub-clinical Cardiovascular (CV) disease, despite the effectiveness of combined Antiretroviral Therapy (cART). Algorithms developed to predict CV risk in the general population could be inaccurate when applied to PLWH. Myocardial Extra-Cellular Matrix (ECM) expansion, measured by computed tomography, has been associated with an increased CV vulnerability in HIV-negative population. Measurement of Myocardial Extra-Cellular Volume (ECV) by computed tomography or magnetic resonance, is considered a useful surrogate for clinical evaluation of ECM expansion. In the present study, we aimed to determine the extent of cardiovascular involvement in asymptomatic HIV-infected patients with the use of a comprehensive cardiac computed tomography (CCT) approach.Materials and methods: In the present study, ECV in low atherosclerotic CV risk PLWH was compared with ECV of age and gender matched HIV- individuals. 53 asymptomatic HIV+ individuals (45 males, age 48 (42.5-48) years) on effective cART (CD4+ cell count: 450 cells/μL (IQR: 328-750); plasma HIV RNA: <37 copies/ml in all subjects) and 18 age and gender matched controls (14 males, age 55 (44.5-56) years) were retrospectively enrolled. All participants underwent CCT protocol to obtain native and postcontrast Hounsfield unit values of blood and myocardium, ECM was calculated accordingly.Results: The ECV was significantly higher in HIV+ patients than in the control group (ECV: 31% (IQR: 28%-31%) vs 27.4% (IQR: 25%-28%), p<0.001). The duration of cART (standardized β=0.56 (0.33-0.95), p=0.014) and the years of exposure to HIV infection (standardized β=0.53 (0.4-0.92), p<0.001), were positively and strongly associated with ECV values. Differences in ECV (p<0.001) were also observed regarding the duration of cART exposure (<5 years, 5-10 years and >10 years). Moreover, ECV was independently associated with age of participants (standardized β = 0.42 (0.33-0.89), p=0.084).Conclusions: HIV infection and exposure to antiretrovirals play a detrimental role on ECV expansion. An increase in ECV indicates ECM expansion, which has been associated to a higher CV risk in the general population. The non-invasive evaluation of ECM trough ECV could represent an important tool to further understand the relationship between HIV infection, cardiac pathophysiology and the increased CV risk observed in PLWH.

scholarly journals Unexpected increase of myocardial extracellular volume fraction in low cardiovascular risk HIV patients

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Cristian Borrazzo ◽  
Gabriella d’Ettorre ◽  
Giancarlo Ceccarelli ◽  
Massimiliano Pacilio ◽  
Letizia Santinelli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
General Population ◽  
Hiv Infection ◽  
Volume Fraction ◽  
Control Group ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Age And Gender ◽  
And Gender ◽  
Asymptomatic Hiv

Abstract Background People living with HIV (PLWH) are prone to develop sub-clinical Cardiovascular (CV) disease, despite the effectiveness of combined Antiretroviral Therapy (cART). Algorithms developed to predict CV risk in the general population could be inaccurate when applied to PLWH. Myocardial Extra-Cellular Matrix (ECM) expansion, measured by computed tomography, has been associated with an increased CV vulnerability in HIV-negative population. Measurement of Myocardial Extra-Cellular Volume (ECV) by computed tomography or magnetic resonance, is considered a useful surrogate for clinical evaluation of ECM expansion. In the present study, we aimed to determine the extent of cardiovascular involvement in asymptomatic HIV-infected patients with the use of a comprehensive cardiac computed tomography (CCT) approach. Materials and methods In the present study, ECV in low atherosclerotic CV risk PLWH was compared with ECV of age and gender matched HIV- individuals. 53 asymptomatic HIV + individuals (45 males, age 48 (42.5–48) years) on effective cART (CD4 + cell count: 450 cells/µL (IQR: 328–750); plasma HIV RNA: <37 copies/ml in all subjects) and 18 age and gender matched controls (14 males, age 55 (44.5–56) years) were retrospectively enrolled. All participants underwent CCT protocol to obtain native and postcontrast Hounsfield unit values of blood and myocardium, ECM was calculated accordingly. Results The ECV was significantly higher in HIV + patients than in the control group (ECV: 31% (IQR: 28%-31%) vs. 27.4% (IQR: 25%-28%), p < 0.001). The duration of cART (standardized β = 0.56 (0.33–0.95), p = 0.014) and the years of exposure to HIV infection (standardized β = 0.53 (0.4–0.92), p < 0.001), were positively and strongly associated with ECV values. Differences in ECV (p < 0.001) were also observed regarding the duration of cART exposure (< 5 years, 5–10 years and > 10 years). Moreover, ECV was independently associated with age of participants (standardized β = 0.42 (0.33–0.89), p = 0.084). Conclusions HIV infection and exposure to antiretrovirals play a detrimental role on ECV expansion. An increase in ECV indicates ECM expansion, which has been associated to a higher CV risk in the general population. The non-invasive evaluation of ECM trough ECV could represent an important tool to further understand the relationship between HIV infection, cardiac pathophysiology and the increased CV risk observed in PLWH.

scholarly journals HMGB1/anti-HMGB1 antibodies define a molecular signature of early stages of HIV-Associated Neurocognitive Disorders (HAND)

Heliyon ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. e00245 ◽  
Author(s):  
Marie-Lise Gougeon ◽  
Béatrice Poirier-Beaudouin ◽  
Jacques Durant ◽  
Christine Lebrun-Frenay ◽  
Héla Saïdi ◽  
...  
Keyword(s):  
Neurocognitive Disorders ◽  
Molecular Signature ◽  
Early Stages ◽  
Hiv Associated Neurocognitive Disorders

scholarly journals Unexpected increase of myocardial extracellular volume fraction in low cardiovascular risk HIV patients

2020 ◽  
Author(s):  
CRISTIAN BORRAZZO ◽  
Gabriella d'Ettorre ◽  
Giancarlo Ceccarelli ◽  
Massimiliano Pacilio ◽  
Letizia Santinelli ◽  
...  
Keyword(s):  
Computed Tomography ◽  
General Population ◽  
Hiv Infection ◽  
Volume Fraction ◽  
Control Group ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Age And Gender ◽  
And Gender ◽  
Asymptomatic Hiv

Abstract Background: People living with HIV (PLWH) are prone to develop sub-clinical Cardiovascular (CV) disease, despite the effectiveness of combined Antiretroviral Therapy (cART). Algorithms developed to predict CV risk in the general population could be inaccurate when applied to PLWH. Myocardial Extra-Cellular Matrix (ECM) expansion, measured by computed tomography, has been associated with an increased CV vulnerability in HIV-negative population. Measurement of Myocardial Extra-Cellular Volume (ECV) by computed tomography or magnetic resonance, is considered a useful surrogate for clinical evaluation of ECM expansion. In the present study, we aimed to determine the extent of cardiovascular involvement in asymptomatic HIV-infected patients with the use of a comprehensive cardiac computed tomography (CCT) approach.Materials and methods: In the present study, ECV in low atherosclerotic CV risk PLWH was compared with ECV of age and gender matched HIV- individuals. 53 asymptomatic HIV+ individuals (45 males, age 48 (42.5-48) years) on effective cART (CD4+ cell count: 450 cells/μL (IQR: 328-750); plasma HIV RNA: <37 copies/ml in all subjects) and 18 age and gender matched controls (14 males, age 55 (44.5-56) years) were retrospectively enrolled. All participants underwent CCT protocol to obtain native and postcontrast Hounsfield unit values of blood and myocardium, ECM was calculated accordingly.Results: The ECV was significantly higher in HIV+ patients than in the control group (ECV: 31% (IQR: 28%-31%) vs 27.4% (IQR: 25%-28%), p<0.001). The duration of cART (standardized β=0.56 (0.33-0.95), p=0.014) and the years of exposure to HIV infection (standardized β=0.53 (0.4-0.92), p<0.001), were positively and strongly associated with ECV values. Differences in ECV (p<0.001) were also observed regarding the duration of cART exposure (<5 years, 5-10 years and >10 years). Moreover, ECV was independently associated with age of participants (standardized β = 0.42 (0.33-0.89), p=0.084).Conclusions: HIV infection and exposure to antiretrovirals play a detrimental role on ECV expansion. An increase in ECV indicates ECM expansion, which has been associated to a higher CV risk in the general population. The non-invasive evaluation of ECM trough ECV could represent an important tool to further understand the relationship between HIV infection, cardiac pathophysiology and the increased CV risk observed in PLWH.

scholarly journals HIV-Associated Neurocognitive Disorders: A Global Perspective

2017 ◽  
Vol 23 (9-10) ◽  
pp. 860-869 ◽  
Author(s):  
Rowan Saloner ◽  
Lucette A. Cysique
Keyword(s):  
Hiv Infection ◽  
Biomarker Discovery ◽  
Longitudinal Design ◽  
Neurocognitive Disorders ◽  
Global Perspective ◽  
Global Studies ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
The Rich ◽  
Hiv Associated Neurocognitive Disorders

AbstractThe present review on HIV-associated neurocognitive disorders (HAND) provides a worldwide overview of studies that have investigated the rate and neuropsychological (NP) profile of HAND research since the inception of the 2007 HAND diagnostic nomenclature. In the first part, the review highlights some of the current controversies around HAND prevalence rates. In the second part, the review critically assesses some solutions to move the field forward. In the third part, we present the cross-sectional NP profile in non-Western HIV+ cohorts and in relation to Western cohorts’ findings. The adopted global perspective highlights the successful expansion of NP studies in HIV infection to culturally diverse low- to medium-income countries with high HIV burden. These studies have produced interestingly similar rates of HAND whether patients were naïve or treated and/or virally suppressed compared to the rich income countries where the NP research in NeuroHIV has originated. The perspective also demonstrates that globally, the group which is the most representative of the HIV epidemic, and thus at risk for HAND are persons with chronic HIV infection and survivors of past immunosuppression, while in relative terms, those who have been treated early with long-term viral suppression represent a minority. In the last part, we present a review of the naturalistic longitudinal NP global studies in HIV+cohorts, discuss the role of longitudinal design in solving issues around the question of asymptomatic neurocognitive impairment, and the question of biomarker discovery. Finally, we conclude by calling for greater methods and data harmonization at a global level. (JINS, 2017,23, 860–869)

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