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15th Annual Conference of the British HIV Association1-3 April 2009, Liverpool, UK |
COGNITIVE FUNCTION AND BRAIN GREY MATTER CHANGE IN HIV-1 YOUNGER AND OLDER POSITIVE ‘MEN WHO HAVE SEX WITH MEN’ IN THE POST-HAART (HIGHLY ACTIVE ANTIRETROVIRAL THERAPY) ERA
HIV Med 2009 Apr 1-3 (Suppl 1);15:13 (abstract no. O27)
K Towgood1, M Pitkanen1, R Kulasegaram2, G Barker1, S Soni3, M Fisher3, C Bradbeer2 and M Kopelman1
1 Institute of Psychiatry, Kings College London, London, UK, 2 Guy’s and St Thomas’ NHS Foundation Trust, London, UK, 3 Brighton and Sussex University Hospital NHS Trust, Brighton, UK
BACKGROUND: In this study we report on cognitive function and brain grey matter content changes in groups of HIV-1 positive older adults and younger adults when compared to groups of matched negative controls.
METHODS: Extensive neuropsychological, MRI and clinical data have been collected for 20 HIV-1 positive older patients (mean age 58, mean CD4 count 736 cells/ll), 20 HIV-1 positive younger patients (mean age 34, CD4 count 596 cells/ll), 22 matched older controls (mean age 58) and 20 matched younger controls (mean age 32). All patients were asymptomatic, with undetectable HIV-1 viral loads, and had been stable on HAART for at least 6 months prior to enrolment in the study. All patients and controls were also screened to ensure they were medically and psychiatrically stable and free from confounding conditions such as depression, heavy drug and alcohol usage or previous neurological injury.
RESULTS: The analysis revealed a slight increase in prevalence of cognitive impairment in the HIV-1 positive older group when compared to the matched negative controls (15% versus 9%) and in the HIV-1 positive younger group when compared to their matched negative controls (15% versus 10%). These increases were not found to be statistically significant. We did however detect significant differences in the grey matter content in the brains of both the HIV-1 positive older and younger patient groups on the volume based morphometry analysis of the structural MRI data.
CONCLUSIONS: Whilst there was a slightly increased rate of cognitive impairment in the HIV-1 positive groups, these results were not found to be statistically significant. Results from this study are therefore consistent with existing evidence that suggests that asymptomatic HIV-1 disease does not impair cognitive function. We did however find significant brain grey matter content loss. This may suggest that structural brain changes are present in HIV-1 positive patients despite intact cognitive function and may indeed precede the appearance of detectable cognitive change.
2009-04-01
O27
Copyright © 2009 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD