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Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age

ART interruption in children can occur especially in resource-limited settings for reasons including poor adherence, stock-outs, ART intolerance of non-pediatric formulas and pill size, as well as ultimately to test for HIV remission. Although early ART initiation is now standard of care in pediatri...

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Autores principales: Nwosu, Emmanuel C., Holmes, Martha J., Cotton, Mark F., Dobbels, Els, Little, Francesca, Laughton, Barbara, van der Kouwe, Andre, Meintjes, Ernesta M., Robertson, Frances
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211921/
https://www.ncbi.nlm.nih.gov/pubmed/34179869
http://dx.doi.org/10.1016/j.ibneur.2021.02.001
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author Nwosu, Emmanuel C.
Holmes, Martha J.
Cotton, Mark F.
Dobbels, Els
Little, Francesca
Laughton, Barbara
van der Kouwe, Andre
Meintjes, Ernesta M.
Robertson, Frances
author_facet Nwosu, Emmanuel C.
Holmes, Martha J.
Cotton, Mark F.
Dobbels, Els
Little, Francesca
Laughton, Barbara
van der Kouwe, Andre
Meintjes, Ernesta M.
Robertson, Frances
author_sort Nwosu, Emmanuel C.
collection PubMed
description ART interruption in children can occur especially in resource-limited settings for reasons including poor adherence, stock-outs, ART intolerance of non-pediatric formulas and pill size, as well as ultimately to test for HIV remission. Although early ART initiation is now standard of care in pediatric HIV management, very little is known on the effect of early ART initiation or subsequent interruption on brain development. This study aimed to investigate the effect of ART interruption on brain cortical thickness (CT) and folding in a subset of children from the Children with HIV Early antiRetroviral therapy (CHER) trial cohort who all started ART before 18 months of age. CHER participants in the neuroimaging follow-up study had magnetic resonance (MRI) scans on a 3T Siemens Allegra brain scanner at age 5.44 ± 0.37 years. MR images were processed using the automated cross-sectional stream in FreeSurfer v6.0 and vertex wise comparisons of CT and local gyrification indices (LGIs) were performed between HIV+ children and HIV- controls, as well as between HIV+ children on interrupted or continuous ART and controls. HIV+ children (n = 46) showed thicker cortex than HIV- children (n = 29) in bilateral frontal and left temporo-insular regions but lower LGIs in left superior and bilateral medial orbitofrontal cortex extending into rostral anterior cingulate. Children on interrupted ART (n = 21) had thicker cortex than HIV- controls in left frontal and right insular regions, but children on continuous treatment (n = 25) showed no difference from controls. Children on both interrupted and continuous ART showed region-specific alterations in LGI relative to controls. Cortical folding appears more sensitive than CT to early life events including early ART and interruption. However, immune health resilience in children can translate to long term preservation of morphometric brain development, especially for those on early and continuous treatment.
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spelling pubmed-82119212021-06-25 Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age Nwosu, Emmanuel C. Holmes, Martha J. Cotton, Mark F. Dobbels, Els Little, Francesca Laughton, Barbara van der Kouwe, Andre Meintjes, Ernesta M. Robertson, Frances IBRO Neurosci Rep Research Paper ART interruption in children can occur especially in resource-limited settings for reasons including poor adherence, stock-outs, ART intolerance of non-pediatric formulas and pill size, as well as ultimately to test for HIV remission. Although early ART initiation is now standard of care in pediatric HIV management, very little is known on the effect of early ART initiation or subsequent interruption on brain development. This study aimed to investigate the effect of ART interruption on brain cortical thickness (CT) and folding in a subset of children from the Children with HIV Early antiRetroviral therapy (CHER) trial cohort who all started ART before 18 months of age. CHER participants in the neuroimaging follow-up study had magnetic resonance (MRI) scans on a 3T Siemens Allegra brain scanner at age 5.44 ± 0.37 years. MR images were processed using the automated cross-sectional stream in FreeSurfer v6.0 and vertex wise comparisons of CT and local gyrification indices (LGIs) were performed between HIV+ children and HIV- controls, as well as between HIV+ children on interrupted or continuous ART and controls. HIV+ children (n = 46) showed thicker cortex than HIV- children (n = 29) in bilateral frontal and left temporo-insular regions but lower LGIs in left superior and bilateral medial orbitofrontal cortex extending into rostral anterior cingulate. Children on interrupted ART (n = 21) had thicker cortex than HIV- controls in left frontal and right insular regions, but children on continuous treatment (n = 25) showed no difference from controls. Children on both interrupted and continuous ART showed region-specific alterations in LGI relative to controls. Cortical folding appears more sensitive than CT to early life events including early ART and interruption. However, immune health resilience in children can translate to long term preservation of morphometric brain development, especially for those on early and continuous treatment. Elsevier 2021-02-10 /pmc/articles/PMC8211921/ /pubmed/34179869 http://dx.doi.org/10.1016/j.ibneur.2021.02.001 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Paper
Nwosu, Emmanuel C.
Holmes, Martha J.
Cotton, Mark F.
Dobbels, Els
Little, Francesca
Laughton, Barbara
van der Kouwe, Andre
Meintjes, Ernesta M.
Robertson, Frances
Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age
title Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age
title_full Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age
title_fullStr Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age
title_full_unstemmed Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age
title_short Cortical structural changes related to early antiretroviral therapy (ART) interruption in perinatally HIV-infected children at 5 years of age
title_sort cortical structural changes related to early antiretroviral therapy (art) interruption in perinatally hiv-infected children at 5 years of age
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211921/
https://www.ncbi.nlm.nih.gov/pubmed/34179869
http://dx.doi.org/10.1016/j.ibneur.2021.02.001
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