Brain volumetrics differ by Fiebig stage in acute HIV infection.

TitleBrain volumetrics differ by Fiebig stage in acute HIV infection.
Publication TypeJournal Article
Year of Publication2023
AuthorsBolzenius, J, Sacdalan, C, Ndhlovu, LC, Sailasuta, N, Trautmann, L, Tipsuk, S, Crowell, TA, Suttichom, D, Colby, DJ, Phanuphak, N, Chan, P, Premeaux, T, Kroon, E, Vasan, S, Hsu, DC, Valcour, V, Ananworanich, J, Robb, ML, Ake, JA, Pohl, KM, Sriplienchan, S, Spudich, S, Paul, R
Corporate AuthorsRV254/SEARCH010, RV304/SEARCH013 Study Teams
Date Published2023 May 01
KeywordsAdolescent, Adult, Brain, Cross-Sectional Studies, HIV, HIV Infections, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Young Adult

OBJECTIVE: People with chronic HIV exhibit lower regional brain volumes compared to people without HIV (PWOH). Whether imaging alterations observed in chronic infection occur in acute HIV infection (AHI) remains unknown.

DESIGN: Cross-sectional study of Thai participants with AHI.

METHODS: One hundred and twelve Thai males with AHI (age 20-46) and 18 male Thai PWOH (age 18-40) were included. Individuals with AHI were stratified into early (Fiebig I-II; n  = 32) and late (Fiebig III-V; n  = 80) stages of acute infection using validated assays. T1-weighted scans were acquired using a 3 T MRI performed within five days of antiretroviral therapy (ART) initiation. Volumes for the amygdala, caudate nucleus, hippocampus, nucleus accumbens, pallidum, putamen, and thalamus were compared across groups.

RESULTS: Participants in late Fiebig stages exhibited larger volumes in the nucleus accumbens (8% larger; P  = 0.049) and putamen (19%; P  < 0.001) when compared to participants in the early Fiebig. Compared to PWOH, participants in late Fiebig exhibited larger volumes of the amygdala (9% larger; P  = 0.002), caudate nucleus (11%; P  = 0.005), nucleus accumbens (15%; P  = 0.004), pallidum (19%; P  = 0.001), and putamen (31%; P  < 0.001). Brain volumes in the nucleus accumbens, pallidum, and putamen correlated modestly with stimulant use over the past four months among late Fiebig individuals ( P s < 0.05).

CONCLUSIONS: Findings indicate that brain volume alterations occur in acute infection, with the most prominent differences evident in the later stages of AHI. Additional studies are needed to evaluate mechanisms for possible brain disruption following ART, including viral factors and markers of neuroinflammation.

Alternate JournalAIDS
PubMed ID36723491
PubMed Central IDPMC10079583
Grant ListR01 MH104141 / MH / NIMH NIH HHS / United States
R01 MH113406 / MH / NIMH NIH HHS / United States
R01 MH113560 / MH / NIMH NIH HHS / United States
U01 AA017347 / AA / NIAAA NIH HHS / United States