Chulalongkorn Medical Journal


Background: Several studies have reported human immunodeficiency virus (HIV) effects on brain volume and found white matter signal abnormality (WMSA) on brain magnetic resonance imaging (MRI). Objective: To evaluate brain volume and WMSA of antiretroviral therapy (ART)-treated perinatally-acquired HIV infected (PHIV) young children. Methods: From November 2016 to March 2018, MRI of 19 ART-treated PHIV young children, aged 12 - 56 months, were analyzed for structural brain volume using FreeSurfer software with manual correction. WMSA were classified into 4 grades. Comparison between the brain volumes and WMSA between early and late ART-treated groups as well as changes of the brain volumes after 1-year follow-up were investigated. The correlations between MRI data and neurodevelopment were explored. Results: Mean differences of total intracranial volume (TICV), total brain volume (TBV), and cerebral WM volume were significantly increased (P < 0.05) in the early ART-treated group after 1-year follow-up. WMSA was seen in most patients (n = 16, 79.0%). The positive correlations of higher severity of WMSA with very early age at start of ART and with lower early learning composite (ELC) scores were found. Conclusion: Brain volume in the early ART-treated PHIV group tends to grow more after 1-year follow-up. A higher severity degree of WMSA was significantly associated with very early ART treatment and poorer neurodevelopment.


Faculty of Medicine, Chulalongkorn University

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