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- Title
Initiation of antiretroviral therapy after the critical neuronal developmental period of the second postnatal year affects white matter microstructure in adolescents living with HIV.
- Authors
Hoare, Jacqueline; Heany, Sarah J.; Fouche, Jean-Paul; Phillips, Nicole; Joska, John A.; Myer, Landon; Zar, Heather J.; Stein, Dan J.
- Abstract
Rapid maturation of major white matter pathways occurs in the first 2 years of life, indicating a critical neuronal developmental period. The impact of initiating antiretroviral therapy (ART) in children perinatally infected with HIV-1, after the age of 2 years on neurocognitive functioning and white matter development in adolescence has not been studied. Forty-six adolescents who initiated ART during the first 2 years of life (< 2 years) and 79 adolescents who initiated ART after 2 years of age (> 2 years), with perinatally acquired HIV were enrolled in the Cape Town Adolescent Antiretroviral Cohort. Adolescents completed a comprehensive neurocognitive battery testing a number of cognitive domains. Diffusion tensor imaging (DTI) was done to determine fractional anisotropy (FA), mean diffusivity (MD), axial diffusion (AD), and radial diffusion (RD) in a region of interest analysis. Neurocognitive performance was similar between adolescents who initiated ART < 2 years or > 2 years. There was a trend towards attention (p =.07) and working memory (p =.05) being poorer in the group who initiated ART > 2 years. FA was lower in the > 2-year group in the superior corona radiata (p =.03), and the external capsule (p =.04). MD was higher in the > 2-year group in the cerebral peduncle (p =.02), the superior corona radiata (p =.01), and the superior fronto-occipital fasciculus (p =.03). RD was higher in the > 2-year group in the superior corona radiata (p =.02), the cerebral peduncle (p =.01), and the superior fronto-occipital fasciculus (p =.01). However, the higher AD in the > 2-year group in the superior corona radiata was not in the expected direction (p =.01). Initiation of ART after the neuronal development period of the second postnatal year is associated with white matter alterations on neuroimaging.
- Subjects
CAPE Town (South Africa); ADOLESCENCE; VOXEL-based morphometry; PUERPERIUM; DIFFUSION tensor imaging; HIV; COGNITIVE testing
- Publication
Journal of NeuroVirology, 2019, Vol 25, Issue 2, p254
- ISSN
1355-0284
- Publication type
Article
- DOI
10.1007/s13365-018-0712-7