State Key Laboratory of Magnetic Resonance and Atomic and Molecular Physics, National Center for Magnetic Resonance in Wuhan, Wuhan Institute of Physics and Mathematics, Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences.
University of Chinese Academy of Sciences, Beijing, China.
AIDS. 2024 Feb 1;38(2):207-215. doi: 10.1097/QAD.0000000000003759. Epub 2023 Oct 19.
Suboptimal concentration of the antiretroviral drug is insufficient to inhibit HIV destruction on brain structure and function due to the resistance of blood brain barrier. We aimed to investigate highly active antiretroviral therapy (HAART)-related effects on the morphological connectivity in people with HIV (PWH).
Case-control study.
Fifty-five HAART-treated for more than 3 months and 54 untreated PWH, as well as 66 demographically matched healthy controls underwent a high-resolution 3D T1-weighted MRI. Individual-level morphological brain network based on gray matter volume of 90 brain regions was constructed and network topological properties were analyzed. Network-based statistics (NBS) was performed to identify sub-networks showing significant differences in morphological connectivity. Correlation and mediation analyses were employed to evaluate associations between the morphological properties and clinical variables of PWH.
Although PWH exhibited small-world architecture in their morphological brain networks, untreated PWH demonstrated altered network properties while HAART-treated PWH showed relatively similar network properties compared to healthy controls. Furthermore, HAART-related effects were mainly involved the bilateral putamen and left thalamus. The findings of NBS further indicated the cortico-striatum-thalamic-cortical loop was involved in the therapeutic-associated morphological network. The positive correlations between the HAART treatment and nodal degree and efficiency of the putamen were mediated by the number of CD4 + T lymphocytes.
The topological properties are recovered to normal in PWH after HAART and the effects induced by HAART are mostly within the cortical-subcortical circuit.
由于血脑屏障的耐药性，抗逆转录病毒药物的浓度不足会影响其对大脑结构和功能的抑制作用，从而导致抗逆转录病毒治疗（HAART）效果不佳。本研究旨在探讨 HAART 对人类免疫缺陷病毒（HIV）感染者（PWH）大脑形态连通性的影响。
病例对照研究。
本研究纳入 55 名接受 HAART 治疗超过 3 个月的 PWH 和 54 名未经治疗的 PWH，以及 66 名年龄匹配的健康对照者，所有参与者均接受高分辨率 3D T1 加权 MRI 检查。基于 90 个脑区的灰质体积构建个体水平的形态脑网络，并分析网络拓扑属性。采用基于网络的统计学（NBS）方法识别形态连通性存在显著差异的子网络。同时还进行了相关性和中介分析，以评估 PWH 的形态学特征与临床变量之间的关系。
尽管 PWH 的形态脑网络具有小世界拓扑结构，但未经治疗的 PWH 表现出网络属性改变，而 HAART 治疗的 PWH 与健康对照组相比，网络属性相对相似。此外，HAART 相关的影响主要涉及双侧壳核和左侧丘脑。NBS 的结果进一步表明，皮质-纹状体-丘脑-皮质回路参与了治疗相关的形态网络。HAART 治疗与壳核节点度和效率的正相关关系是由 CD4 + T 淋巴细胞数量介导的。
HAART 后 PWH 的拓扑性质恢复正常，HAART 诱导的影响主要在皮质-皮质下回路内。
