文摘
摘要目的:识别和描述神经退行性生物型在艾滋病毒感染者(PWH)。
背景:PWH可能出现脑萎缩和神经认知功能障碍尽管抑制的抗逆转录病毒治疗。生物型的区别在这个人口是至关重要的,因为它们可能代表独特的潜在的病理生理机制和需要不同的治疗方法。
设计/方法:参与大型的纵向自然历史研究,特征明显,不同群体的PWH和匹配控制经历了深表现型包括核磁共振和神经心理测试。皮层下灰质(SGM)和心室容量说明来自FreeSurfer,然后转换成百分位数调整年龄、性别、头骨大小和核磁共振成像扫描仪。百分比和临床变量之间的相关系数计算。连续临床变量逻辑回归评估影响二进制百分位数。
结果:我们组包括209 PWH(159男,50名女性)和64名对照(34岁男性,30名女)。20最差的子集th百分位的SGM萎缩(n = 51)或心室扩大(n = 77)。在PWH SGM萎缩(n = 43),分析控制了年龄,性别,和智商显示总体积极联系t指数(r = 0.41, p = 0.008);执行(r = 0.43, p = 0.004),学习(r = 0.37, p = 0.015),内存(r = 0.38, p = 0.014)和电机(r = 0.36, p = 0.021)域;和全球赤字得分(GDS) (r =−0.37, p = 0.015)。有趣的是,SGM百分位数与总胆固醇也负相关(r =−0.44, p = 0.014)。心室扩大,降低总体t指数在HIV阳性男性(或= 0.92,CI = 0.87 - -0.98, p = 0.011)和HIV +女性(或= 0.89,CI = 0.80 - -0.98, p = 0.032)。在HIV阳性男性,心室扩大与减少口头(或= 0.94,CI = 0.89 - -0.98, p = 0.010),信息处理的速度(或= 0.96,CI = 0.91 - -1.00, p = 0.037),和运动(或= 0.94,CI = 0.89 - -0.98, p = 0.004)的性能。HIV +的女性,这是增加GDS(或= 8.20,CI = 1.43 - -81.56, p = 0.042)和收缩压(或= 1.04,CI = 1.00 - -1.09, p = 0.038)。
结论:可以分为SGM PWH与神经退化萎缩或心室扩大生物型。这些子集与不同的神经认知赤字和临床危险因素,提出不同的潜在的病理生理机制。
披露:迪特里希女士没有披露。麦克马汉女士没有披露。天下没有披露。Bhagavatheeshwaran先生也收到了来自美国国立卫生研究院的研究支持。Reich博士收到NIH的研究支持。帝国已经收到博士研究的机构支持顶点药品。帝国已经收到博士研究的机构阿德尔森医疗研究基金会的支持。帝国已经收到博士研究的机构支持髓修复的基础。Reich博士的机构已经接到Sanofi-Genzyme研究支持。Reich博士的机构收到Abata疗法的研究支持。 The institution of Dr. Reich has received research support from National Multiple Sclerosis Society. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with PeerView. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a CME Faculty with AcademicCME. Dr. Reich has a non-compensated relationship as a Advisor with Sanofi-Genzyme that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Board of Directors with ACTRIMS that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Abata Therapeutics that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Roche that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with American Brain Foundation that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with University of Basel RC2NB that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Multiple Sclerosis Society of Canada that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Tuscan Doctorate in Neuroscience that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Editorial Board with Multiple Sclerosis Journal that is relevant to AAN interests or activities. Dr. Reich has a non-compensated relationship as a Advisor with Glaxo-Smith-Kline that is relevant to AAN interests or activities. Dr. Snow has received research support from NIH/NIMH. The institution of Anuradha Ganesan has received research support from NIAID. Dr. Berjohn has received personal compensation in the range of $100,000-$499,999 for serving as a Active Duty Physician salary with US Navy. Brian K. Agan has received personal compensation for serving as an employee of Henry M. Jackson Foundation for the Advancement of Military Medicine. Dr. Nath has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Nath has received research support from National Institutes of Health. The institution of Dr. Nath has received research support from ALS Association. Dr. Smith has nothing to disclose.
