Clinical research cerebral MRI findings in HIV-positive subjects and appropriate controls

Chhabra, Srishti; Underwood, Jonathan; Cole, James H.; Caan, Matthan W.A.; Waldman, Adam; Reiss, Peter; Sabin, Caroline; Sharp, David J.; Winston, Alan

doi:10.1097/qad.0000000000001910

Cited by 4 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Increasing age was the only factor correlated with more frequent incidental findings. A smaller study comparing patients with HIV infection and demographically matched controls had similar findings, although in this study, the neuroradiologist was not blinded to the participant serostatus which may have led to some bias in reporting 3 .…”

Section: Discussionmentioning

confidence: 53%

“…Because of this increase in imaging ability, investigators are better able to detect changes in neuroanatomy and function. With this tendency towards higher processing power, however, has come increasing incidence of incidental findings, both in imaging studies performed for research purposes and for clinical care [1][2][3] . Incidental findings are defined as "a finding concerning an individual research participant that has potential health or reproductive importance and is discovered during conducting research but is beyond the aims of the study" 2 .…”

mentioning

confidence: 99%

“…Incidental findings are defined as "a finding concerning an individual research participant that has potential health or reproductive importance and is discovered during conducting research but is beyond the aims of the study" 2 . Recent studies have found that incidental findings are found on up to 48% of structural MRI studies 3,4 . These incidental findings pose an ethical dilemma, as they often require further workup and diagnostic evaluation, resulting in increased patient anxiety, and increased cost to healthcare systems.…”

mentioning

confidence: 99%

“…Although severe neurocognitive impairment has become rare over the last decade, HAND remains a prominent area of research as scientists and clinicians attempt to understand the effects of chronic HIV infection on the brain 10 . To date, there has been only one study that has reported rates of incidental findings on brain MRI in PWH or characterization of those findings 3 .…”

mentioning

confidence: 99%

See 3 more Smart Citations

Incidental Findings on Brain MRI in People with HIV Infection

Hanna

Sayles

White

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Background: Incidental findings are a well-known complication of imaging studies done for both diagnostic and research purposes. Little is known about the rates and types of incidental findings found on brain MRI in patients with HIV infection, who may be at risk for HIV-Associated Neurocognitive Disorders (HAND). Methods: The parent study included 108 adults with HIV infection and 125 demographically-matched uninfected controls who completed MRI and neuropsychological testing. Incidental findings were classified by the study team as vascular, neoplastic, congenital, other neurologic, or non-neurologic. Categorical measures were compared using Pearson chi-square tests; continuous measures were compared using t-tests. Results: Among participants with HIV infection, 36/108 (33%) had incidental findings compared to 33/125 (26%) controls (p = 0.248). Rates of incidental findings were significantly correlated with increasing age in both participants with HIV infection (p = 0.013) and controls (p = 0.022). We found no correlation between presence of incidental findings and sex or race/ethnicity among either cohort, and no correlation with CD4 count or HAND status for the HIV-infected cohort. Conclusions: Incidental findings were common in both participants with HIV infection and controls, at higher rates than previously reported in healthy populations. there was no significant difference in prevalence between the groups.

show abstract

Section: Discussionmentioning

confidence: 53%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Incidental Findings on Brain MRI in People with HIV Infection

Hanna

Sayles

White

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…One study reported HIV-status to be an independent risk factor for cerebral small vessel disease, including WMH [ 4 ]. Finally, two smaller studies, however, did not report HIV-status to be associated with prevalence and volume of WMH [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Differences in location of cerebral white matter hyperintensities in children and adults living with a treated HIV infection: A retrospective cohort comparison

et al. 2020

Self Cite

View full text Add to dashboard Cite

Cerebral white matter hyperintensities (WMH) persist in children and adults living with HIV, despite effective combination antiretroviral therapy (cART). As age and principal routes of transmission differ between children (perinatally) and adults (behaviorally), comparing the characteristics and determinants of WMH between these populations may increase our understanding of the pathophysiology of WMH. From separate cohorts of 31 children (NOVICE) and 74 adults (AGE h IV), we cross-sectionally assessed total WMH volume and number of WMH per location (periventricular vs. deep) using fluid-attenuated inversion recovery (FLAIR) MRI images. WMH were either periventricular when within 10mm of the lateral ventricles, or deep otherwise. We assessed patient- or HIV-related determinants of total WMH volume (adjusted for intracranial volume) and location of WMH using logistic regression, while stratifying on children and adults. At enrollment, median age of participants was 13.8 years (IQR 11.4–15.9) for children and 53.4 years (IQR 48.3–60.8) for adults and 27/31 children (87%) and 74/74 adults (100%) had an HIV RNA viral load <200 copies/mL. WMH were present in 16/27 (52%) children and 74/74 adults (100%). The prevalence of deep WMH was not different between groups, (16/16 [100%] in children vs. 71/74 [96%] in adults, p = 0,999), yet periventricular WMH were more prevalent in adults (74/74 [100%]) compared to children (9/16; 56%) ( p <0.001). Median WMH volume was higher in adults compared to children (1182 mm 3 [425–2617] vs. 109 mm 3 [61.7–625], p <0.001). In children, boys were more likely to have deep WMH compared to girls. In adults, older age was associated with higher total WMH volume, and age, hypertension and lower CD4 + T-lymphocyte nadir with a higher number of periventricular WMH. Our findings suggest that the location of WMH differs between children and adults living with HIV, hinting at a different underlying pathogenesis.

show abstract

The impact of HIV central nervous system persistence on pathogenesis

Brew

Barnes

2019

Aids

View full text Add to dashboard Cite

Clinical research cerebral MRI findings in HIV-positive subjects and appropriate controls

Cited by 4 publications

References 13 publications

Incidental Findings on Brain MRI in People with HIV Infection

Incidental Findings on Brain MRI in People with HIV Infection

Differences in location of cerebral white matter hyperintensities in children and adults living with a treated HIV infection: A retrospective cohort comparison

The impact of HIV central nervous system persistence on pathogenesis

Contact Info

Product

Resources

About