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and Hepatitis.com Coverage of the
18th Conference on Retroviruses and
Opportunistic Infections (CROI 2011)
February 27 - March 2, 2011, Boston, MA
HIV Enters and Injures Brain Early
Both clinical and laboratory research have shown that HIV injures the brain. As the focus of much research shifts to the long-term consequences of HIV infection, interest in the brain has grown. Several presentations at the 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011) dealt with the effects of HIV on both brain structure and function.
In a talk titled "HIV Brain Viral and Inflammatory Signatures During Acute HIV infection," Victor Valcour of the University of California San Francisco (abstract 54) presented results from a study looking at measures of HIV and inflammation in the brains of people infected with HIV for less than 6 months. These individuals were compared to a matched group of chronically HIV infected people as well as a group of uninfected controls.
This study shows that HIV is present at the earliest stages of HIV infection and leads to early inflammation in the brain. A better understanding of when and how HIV enters the brain should help both researchers and clinicians better deal with the effects of HIV on the brain.
Early Brain Changes
Ann Regin of Northwestern University in Chicago (abstract 55LB) presented results from the a study of the Chicago Early HIV Cohort Study, titled "Injury to the Brain Evident in Early HIV Infection."
This study followed 43 people living with HIV for less than 1 year and compared them to 22 uninfected individuals. Researchers looked at high-resolution images of the brain and measured gray matter volume in a number of brain regions.
This study comparing brain structure of people newly infected with HIV to uninfected individuals shows that HIV injures the brain in the earliest phases of infection. The preliminary results showing a lesser effect in people on HIV treatment bolster the argument for early initiation of ART.
Brain Injury and Inflammation
Branford Navia of Tufts University in Boston (abstract 56) presented results from the HIV Neuroimaging Consortium, titled "Neurologic Injury on Stable ART."
followed 167 people living with HIV over a 2-year period at 7 sites
in the U.S. Researchers looked at changes in cognitive function and
their relation to both HIV treatment and various measures of HIV infection
This analysis shows that both neuropsychological function and brain structure are altered in people on stable antiretroviral treatment. Moreover, the risk of cognitive decline and brain injury were highest in people with the greatest level of immune deficiency and highest levels of inflammation and immune activation in the brain. Disappointingly, though, a greater amount of time on ART did not seem to reduce the risk of brain injury.
HIV Genetic Diversity
Finally, George Hightower of the University of California San Diego (abstract 57) presented results from the CHARTER Group, titled "Higher HIV Genetic Diversity is Associated with AIDS and Neuropsychological Impairment."
This study followed 187 people living with HIV, of whom 80 were men and almost 50% African American. Researchers measured levels of HIV genetic diversity and its effect on both rates of AIDS diagnosis and changes in neuropsychological impairment.
Taken together, these studies present a sobering picture of the effects of HIV on brain function and structure. As people with HIV live longer, such effects become more important and research leading to a better understand of how to predict and affect HIV's impact on the brain become more crucial.
V Valcour, N Sailasuta, T Chalermchai, et al. HIV Brain Viral and Inflammatory Signature during Acute Infection. 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011). Boston. February 27-March 2, 2011. Abstract 54.
A Rangin, Y Wu, H Du, et al. Injury to the Brain Is Evident Early in HIV Infection. 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011). Boston. February 27-March 2, 2011. Abstract 55LB.
B Navia, J Harezlak, G Schifitto, et al. A Longitudinal Study of Neurological Injury in HIV-infected Subjects on Stable ART: The HIV Neuroimaging Consortium Cohort Study. 18th Conference on Retroviruses and Opportunistic Infections (CROI 2011). Boston. February 27-March 2, 2011. Abstract 56.
J Wong, S Letendre, et al. Higher HIV-1 Genetic Diversity Is Associated
with AIDS and Neuropsychological Impairment. 18th Conference on Retroviruses
and Opportunistic Infections (CROI 2011). Boston. February 27-March
2, 2011. Abstract